Individual provider Active NPI

Ann E Vandyke, M.D.

  • Psychiatry Physician
  • Leeds, MA
National Provider Identifier
1619088028
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
76686 Issued in MA
Practice address
421 N Main St
Leeds, MA 01053-9764
Phone
(413) 584-4040
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 76686 MA Primary

Addresses

Primary practice location

421 N Main St
Leeds, MA 01053-9764

Mailing address

421 N Main St
Leeds, MA 01053-9764
Phone (413) 584-4040

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519000267 MA Practitioner - PsychiatryPractitioner - Addiction Medicine 6406897529 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76686MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooley Dickinson Hospital Inc CurrentSince Apr 1, 2016 Accepting new patients
Cooley Dickinson Hospital Inc CurrentSince Apr 1, 2016 Accepting new patients
Hampshire Pathologists, Inc. Current Accepting new patients
Baystate Franklin Medical Center Past Accepting new patients
Baystate Franklin Medical Center Past Accepting new patients

Locations

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

Organizations & group practices 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1619088028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N MAIN ST",
            "city": "LEEDS",
            "state": "MA",
            "postal_code": "010539764",
            "telephone_number": "413-584-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N MAIN ST",
            "city": "LEEDS",
            "state": "MA",
            "postal_code": "010539764",
            "telephone_number": "413-584-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "ANN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "76686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leeds, MA

Sources for this page

Verify at the official NPI Registry.