Individual provider Active NPI

Andrea Lyman, M.D

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1639196595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
144296 Issued in NY
Practice address
279 E 3Rd St
New York, NY 10009-7813
Phone
(212) 477-8500
Fax
(212) 473-4970
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 144296 NY Primary

Addresses

Primary practice location

279 E 3Rd St
New York, NY 10009-7813

Mailing address

279 E 3Rd St
New York, NY 10009-7813
Phone (212) 477-8500

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
I20110225000706 NY Practitioner - Family Practice 9133300965 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
144296NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc CurrentSince Oct 14, 2016 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Oct 14, 2016 Accepting new patients
William F Ryan Community Health Center Inc Current Accepting new patients

Locations

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

279 E 3rd St
New York, NY 10009
Phone (212) 477-8500

Organizations & group practices 3

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639196595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 E 3RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097813",
            "telephone_number": "212-477-8500",
            "fax_number": "212-473-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 E 3RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097813",
            "telephone_number": "212-477-8500",
            "fax_number": "212-473-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYMAN",
        "first_name": "ANDREA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "144296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.