Individual provider Active NPI

Marilyn T Lyga, PH.D.

  • Psychologist
  • Basking Ridge, NJ
National Provider Identifier
1265449862
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2061 Issued in NJ
Practice address
105 Madisonville Rd
Basking Ridge, NJ 07920-1665
Phone
(908) 766-6836
NPI assigned
Aug 3, 2006
Last updated
Dec 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2061 NJ Primary

Addresses

Primary practice location

105 Madisonville Rd
Basking Ridge, NJ 07920-1665

Mailing address

105 Madisonville Rd
Basking Ridge, NJ 07920-1665
Phone (908) 766-6836

Other identifiers 4

IdentifierTypeStateIssuer
0519219000OtherNJAMERIHEALTH PPO PIN #
060002061NJ01OtherNJANTHEM HEALTH PIN #
132379000OtherNJMAGELLAN PROVIDER #
4564859OtherNJAETNA PIN#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050602000874 NJ Practitioner - Clinical Psychologist 6709829518 Practice locations: Basking Ridge, NJ; Princeton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

105 Old Madisonville Rd
Basking Ridge, NJ 07920-1665

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2061NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1265449862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MADISONVILLE RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201665",
            "telephone_number": "908-766-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MADISONVILLE RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201665",
            "telephone_number": "908-766-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYGA",
        "first_name": "MARILYN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "2061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO PIN #",
            "identifier": "0519219000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HEALTH PIN #",
            "identifier": "060002061NJ01",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROVIDER #",
            "identifier": "132379000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN#",
            "identifier": "4564859",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Basking Ridge, NJ

Sources for this page

Verify at the official NPI Registry.