Martin J Lan, MD PHD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

256351 Issued in NY

Practice address

547 Saw Mill River Rd # LL4
Ardsley, NY 10502-2143

Phone

(914) 231-7328

NPI assigned

Jun 16, 2008

Sex

Male

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

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 21, 2018 through Mar 21, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1710147525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 SAW MILL RIVER RD # LL4",
            "city": "ARDSLEY",
            "state": "NY",
            "postal_code": "105022143",
            "telephone_number": "914-231-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 SAW MILL RIVER RD # LL4",
            "city": "ARDSLEY",
            "state": "NY",
            "postal_code": "105022143",
            "telephone_number": "914-231-7328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 W 34th St Ph Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100013006",
            "country_code": "US",
            "telephone_number": "212-495-9627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAN",
        "first_name": "MARTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "256351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Krsulich, M.S., R.D.
• Shaimole Jose Kumpiluvely
• Aneesh Kuriakose, DPT
• Jennifer Combs Lalor, M.S., CCC-SLP
• Megan D Lambert, LCSWR
• Theodore Langer
• Madelein Anne Laxamana, P.T.
• Heidi Leabman Gross
• Joanna Lederman
• Simona Rita-Marie Lee, OT

• Psychiatry Physician in Ardsley, NY
• Providers in Ardsley, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.

Verify at the official NPI Registry.