Rebeccah Susanne Lyles, PMH-DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

56563 Issued in NM

Practice address

1608 5TH St NW
Albuquerque, NM 87102-1302

Phone

(312) 882-0432

NPI assigned

Apr 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robben R. Gingery, MD, LLC

  • Geriatric Psychiatry Physician
  • Rio Rancho, NM
  • NPI 1033527015
  Medicare reassignment NPD
• Mind Medicine Clinic LLC

  dba Mind Medicine Clinic

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
  • NPI 1194402503
  NPD Authorized official

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1659066512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 5TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021302",
            "telephone_number": "312-882-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 5TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021302",
            "telephone_number": "312-882-0432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Gibson Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871085566",
            "country_code": "US",
            "telephone_number": "505-254-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYLES",
        "first_name": "REBECCAH",
        "middle_name": "SUSANNE",
        "name_prefix": "Dr.",
        "credential": "PMH-DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "56563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mari Lyford, LMSW
• John Lykins, LMHC
• Faith Lyle
• Janece Marie Lyle, PHARMD
• Gregory Thomas Lyles-Davis
• Lyman S. Atchley DC PC
• David Lyman, M.D.
• Bernadette Irene Lynch, PT
• Jenae Lynch
• Kiyun Maurice Lynch, LAT, ATC

• Psychiatric/Mental Health Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.