Individual provider Active NPI

Phyllis Lynn, CNM

  • Midwife
  • Brooklyn, NY
National Provider Identifier
1497751028
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
F000129-1 Issued in NY
Practice address
6208 4TH Ave
Brooklyn, NY 11220-4616
Phone
(718) 283-8867
Fax
(718) 283-8468
NPI assigned
Jun 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X F000129-1 NY Primary

Addresses

Primary practice location

6208 4TH Ave
Brooklyn, NY 11220-4616

Mailing address

967 48TH St
Brooklyn, NY 11219-2919
Phone (718) 283-6813

Other identifiers 1

IdentifierTypeStateIssuer
07793568MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110721000171 NY Practitioner - Certified Nurse Midwife (CNM) 8921276767 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F000129-1NYMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
MMC OB-GYN Faculty Practice Plan CurrentSince Feb 20, 2019 Accepting new patients
Maimonides Medical Center Current Accepting new patients
MMC OB/GYN Hospital Past Accepting new patients

Locations

1616A Voorhies Ave
Brooklyn, NY 11235
Phone (718) 283-8225

6208 4th Ave
Brooklyn, NY 11220
Phone (718) 283-3000

967 48th St
Fl 2
Brooklyn, NY 11219
Phone (718) 283-7979

967 48th St
Brooklyn, NY 11219
Phone (718) 283-8864

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

4422 9th Ave
#1
Brooklyn, NY 11220

Networks

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

Interoperability endpoints

  • Direct secure messaging: phyllislynn@mai.allscriptsdirect.net

Organizations & group practices 5

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1497751028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192919",
            "telephone_number": "718-283-6813",
            "fax_number": "718-283-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6208 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204616",
            "telephone_number": "718-283-8867",
            "fax_number": "718-283-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "PHYLLIS",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F000129-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07793568",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.