Individual provider Active NPI

Auguste Lytton Duplan, MD

  • Child & Adolescent Psychiatry Physician
  • Ithaca, NY
National Provider Identifier
1689649980
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
229792 Issued in NY
Practice address
101 Dates Dr
Cayuga Medical Center at Ithaca
Ithaca, NY 14850-1342
Phone
(607) 274-4623
Fax
(607) 274-4130
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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 229792-1 NY
Child & Adolescent Psychiatry Physician 2084P0804X 229792 NY Primary

Addresses

Primary practice location

101 Dates Dr
Cayuga Medical Center at Ithaca
Ithaca, NY 14850-1342

Mailing address

101 Dates Dr
Cayuga Medical Center at Ithaca
Ithaca, NY 14850-1342
Phone (607) 274-4623

Other identifiers 1

IdentifierTypeStateIssuer
02580927MedicaidNY

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
I20040819000453 NY Practitioner - Psychiatry 2365415098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Cayuga Medical Center at IthacaGroup PAC ID 7214847367, 34 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4443

1257 Trumansburg Rd
Ithaca, NY 14850-1313
Phone (607) 273-0811

249 Glenwood Rd
Binghamton, NY 13905-1603
Phone (607) 770-0211

305 Main St
Binghamton, NY 13905-2524
Phone (607) 729-1295

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229792-1NYMDPsychiatry Physician
229792NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Center at Ithaca CurrentSince May 8, 2017 Accepting new patients
Cayuga Pathology PLLC Current Accepting new patients
State of New York Comptrollers Office CurrentSince Jun 1, 2019 Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince May 8, 2017 Accepting new patients
State of New York Comptrollers Office CurrentSince Jun 1, 2019 Accepting new patients
Cayuga Medical Center at Ithaca Past Accepting new patients

Locations

44 Holland Ave
Fl 4
Albany, NY 12208

305 Main St
Binghamton, NY 13905
Phone (607) 729-1295

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1689649980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "address_2": "CAYUGA MEDICAL CENTER AT ITHACA",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4623",
            "fax_number": "607-274-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "address_2": "CAYUGA MEDICAL CENTER AT ITHACA",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4623",
            "fax_number": "607-274-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPLAN",
        "first_name": "AUGUSTE",
        "middle_name": "LYTTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "229792-1",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "229792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02580927",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.