NPIMap

Organization Active NPI

Lumin Health PG

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newton, MA
National Provider Identifier
1538819909
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LUMIN HEALTH PG
Practice address
10 Langley Rd Ste 200
Newton, MA 02459-1972
Phone
(617) 863-8810
Fax
(617) 863-8844
NPI assigned
Mar 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Dr. Benjamin Louis Yudkoff, MDNPI 1962727966
Title
Owner
Phone
(201) 953-0432

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

10 Langley Rd Ste 200
Newton, MA 02459-1972

Mailing address

10 Langley Rd Ste 200
Newton, MA 02459-1972
Phone (617) 863-8810

Other practice location 1

50 Church St Fl 3
Cambridge, MA 02138-3726
Phone (617) 863-8810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220512000770 MA Part B Supplier - Clinic/Group Practice 3678950649 Receives reassigned benefits from 25 practitioners
Practice locations: Newton, MA; Woburn, MA; Cambridge, MA; Brookline, MA

National Provider Directory

National Provider Directory

Locations

1101 Beacon St
#6E
Brookline, MA 02446
Phone (617) 277-0700

1101 Beacon St
#4E
Brookline, MA 02446
Phone (617) 232-6350

50 Church St
Fl 3
Cambridge, MA 02138
Phone (617) 340-7959

1280 Centre St
Ste 225
Newton Center, MA 02459
Phone (617) 630-1918

53 Langley Rd
Ste 250
Newton Center, MA 02459
Phone (617) 863-8810

300 Tradecenter
Ste 3400
Woburn, MA 01801
Phone (617) 863-8810

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1538819909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LANGLEY RD STE 200",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024591972",
            "telephone_number": "617-863-8810",
            "fax_number": "617-863-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LANGLEY RD STE 200",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024591972",
            "telephone_number": "617-863-8810",
            "fax_number": "617-863-8844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Church St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021383726",
            "country_code": "US",
            "telephone_number": "617-863-8810",
            "fax_number": "617-863-8844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUMIN HEALTH PG",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-28",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "YUDKOFF",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-953-0432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.