Individual provider Active NPI

Clifford W Lynd, Jr., M.D.

  • Vascular Surgery Physician
  • York, PA
National Provider Identifier
1477547479
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD013609E Issued in PA
Practice address
25 Monument Rd
Suite 190
York, PA 17403-5060
Phone
(717) 851-6454
Fax
(717) 851-1665
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Vascular Surgery Physician 2086S0129X MD013609E PA Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD013609E PA

Addresses

Primary practice location

25 Monument Rd
Suite 190
York, PA 17403-5060

Mailing address

1803 Mount Rose Ave
Suite B3
York, PA 17403-3026
Phone (717) 851-1405

Other identifiers 10

IdentifierTypeStateIssuer
249457OtherPAUNISON-WMG
037208100MedicaidMD
548801OtherMDCAREFIRST MD BCBS
1569365OtherPAGATEWAY-WMG
033231OtherPAJOHNS HOPKINS
34317OtherPAGEISINGER HEALTH PLAN
4269079OtherPAAETNA
50080379OtherPACAPITAL BLUE CROSS-WMG
000633873MedicaidPA
20078590OtherPAAMERIHEALTH MERCY-WMG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD013609EPAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Past Accepting new patients
York Endovascular Solutions, PC Specialist PastSince Oct 1, 2005 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1477547479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 MOUNT ROSE AVE",
            "address_2": "SUITE B3",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033026",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MONUMENT RD",
            "address_2": "SUITE 190",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035060",
            "telephone_number": "717-851-6454",
            "fax_number": "717-851-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYND, JR.",
        "first_name": "CLIFFORD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD013609E",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD013609E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG",
            "identifier": "249457",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037208100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "548801",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1569365",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "033231",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "34317",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4269079",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "50080379",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000633873",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "20078590",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.