Active NPI
Kamlyn Haynes, M.D.
- Child & Adolescent Psychiatry Physician
- West Boylston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 158525
- Practice address
- 47 Prospect St
West Boylston, MA 01583-1301 - Phone
- (781) 608-2241
- Fax
- (508) 835-4418
- NPI assigned
- Jan 15, 2006
- Last updated
- Oct 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 158525 | MA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 158525 | MA | Primary |
Addresses
Primary practice location
47 Prospect St
West Boylston, MA 01583-1301
Mailing address
47 Prospect St
West Boylston, MA 01583-1301
Phone (781) 608-2241
Other practice location 1
55 Lake Ave N
Worcester, MA 01655-0002
Phone (774) 443-7962
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group Inc | Psychiatry | Current | Accepting new patients |
| Umass Memorial Medical Group, Inc. | Current | Accepting new patients | |
| The Commonwealth of Massachusetts | Past | Accepting new patients |
Locations
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
Psychiatry
-
dba Urgent Care Express at Harrington
- Urgent Care Clinic/Center
- Oxford, MA
- NPI 1982381018
-
dba Worcester Recovery Center & Hospital
- Psychiatric Hospital
- Worcester, MA
- NPI 1306903042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634256000000",
"number": "1417936667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 PROSPECT ST",
"city": "WEST BOYLSTON",
"state": "MA",
"postal_code": "015831301",
"telephone_number": "781-608-2241",
"fax_number": "508-835-4418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 PROSPECT ST",
"city": "WEST BOYLSTON",
"state": "MA",
"postal_code": "015831301",
"telephone_number": "781-608-2241",
"fax_number": "508-835-4418"
}
],
"practiceLocations": [
{
"address_1": "55 Lake Ave N",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016550002",
"country_code": "US",
"telephone_number": "774-443-7962",
"fax_number": "774-443-7042",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAYNES",
"first_name": "KAMLYN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-15",
"last_updated": "2021-10-15",
"certification_date": "2021-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "158525",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "158525",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in West Boylston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.