Individual provider Active NPI

Haiyan Lu

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1225104797
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
222119 Issued in NY
Practice address
1111 Amsterdam Ave
New York, NY 10025-1716
Phone
(212) 523-8050
NPI assigned
Nov 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 222119 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
New York, NY 10025-1716

Mailing address

159 W 53Rd St Apt 31D
New York, NY 10019-6005

Other identifiers 1

IdentifierTypeStateIssuer
222119OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100618000177 NY Practitioner - Pediatric MedicinePractitioner - Endocrinology 2567592553 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Family Care Center, Inc. CurrentSince Jan 9, 2012 Accepting new patients
University Physicians of Brooklyn, Inc. Current Accepting new patients
Interfaith Professional Physician Services, P.C. Pediatrics CurrentSince Jun 1, 2024 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Apr 7, 2010 Accepting new patients
University Physicians of Brooklyn, Inc. Pediatrics CurrentSince Feb 18, 2019 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Feb 18, 2019 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Apr 7, 2010 Accepting new patients
Brookdale Family Care Center, Inc. Pediatrics Current Accepting new patients
University Physicians of Brooklyn, Inc Past Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients

Locations

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

2554 Linden Blvd
Brooklyn, NY 11208
Phone (718) 240-5132

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: haiyanlu@sunydmc.allscriptsdirect.net
  • Direct secure messaging: hlu1054150@nychhc.direct-ci.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225104797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 W 53RD ST APT 31D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100196005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "HAIYAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "222119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "222119",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.