Active NPI
Lydia Rose Elison, MD
- Psychiatry Physician
- Northampton, MA
National Provider Identifier
1710117536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 240227
- Practice address
- 30 Locust St
Northampton, MA 01060-2052 - Phone
- (413) 582-2151
- Fax
- (413) 582-2838
- NPI assigned
- Jul 15, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 240227 | MA | Primary |
Addresses
Primary practice location
30 Locust St
Northampton, MA 01060-2052
Mailing address
30 Locust St
Northampton, MA 01060-2052
Phone (413) 582-2151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 14, 2015 through Sep 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425513600000",
"number": "1710117536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 LOCUST ST",
"city": "NORTHAMPTON",
"state": "MA",
"postal_code": "010602052",
"telephone_number": "413-582-2151",
"fax_number": "413-582-2838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 LOCUST ST",
"city": "NORTHAMPTON",
"state": "MA",
"postal_code": "010602052",
"telephone_number": "413-582-2151",
"fax_number": "413-582-2838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELISON",
"first_name": "LYDIA",
"middle_name": "ROSE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-15",
"last_updated": "2015-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "240227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northampton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.