Individual provider Active NPI

Naomi Hayes Gwynn, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1629158944
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
226247 Issued in NY
Practice address
119 W 57TH St
Suite 516
New York, NY 10019-2303
Phone
(212) 582-0400
Fax
(212) 582-0400
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 226247 NY Primary
Psychiatry Physician 2084P0800X 040881 CT

Addresses

Primary practice location

119 W 57TH St
Suite 516
New York, NY 10019-2303

Mailing address

119 W 57TH St
Suite 516
New York, NY 10019-2303
Phone (212) 582-0400

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230302000287 NY Order and Referring Only - PsychiatryPractitioner - Psychiatry 2769447390

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040881CTMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1629158944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W 57TH ST",
            "address_2": "SUITE 516",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192303",
            "telephone_number": "212-582-0400",
            "fax_number": "212-582-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W 57TH ST",
            "address_2": "SUITE 516",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192303",
            "telephone_number": "212-582-0400",
            "fax_number": "212-582-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWYNN",
        "first_name": "NAOMI",
        "middle_name": "HAYES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "226247",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "040881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.