Lorna M Seybolt, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

77094 Issued in CT

Practice address

2200 Whitney Ave Ste 290
Hamden, CT 06518-3695

Phone

(203) 903-8308

Fax

(203) 599-3927

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Pediatric MedicineAlso: Infectious Disease

Education

University of Connecticut School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anchor Health Initiative Corp. 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Anchor Health Initiative Corp.

  • Primary Care Clinic/Center
  • Stamford, CT
  • NPI 1245773191

  CT

  Medicare reassignment Care Compare group NPD
• Anchor Health Initiative Corp.

  • Community/Retail Pharmacy
  • Stamford, CT
  • NPI 1518425578
  Care Compare group NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1508950247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 WHITNEY AVE STE 290",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183695",
            "telephone_number": "203-903-8308",
            "fax_number": "203-599-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WHITNEY AVE STE 290",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183695",
            "telephone_number": "203-903-8308",
            "fax_number": "203-599-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYBOLT",
        "first_name": "LORNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "CT",
            "license": "77094",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "77094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2171070",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "332740YH58",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serene Mindscape Counseling LLC
• Jacqueline S Servidio, LCSW
• Suzanne Serviss, LCSW
• Marley Anderson Sessa, OTR/L
• Lynne Severance, APRN
• SF Connecticut Medical Services PC
• Jalpaben Abhishek Shah
• Purvi Deepak Shah, PH.D.
• Shahin Shaikh, PA-C
• Maria R Shanley, RPT

• All providers in Hamden, CT
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.