Active NPI
Lyn Jonson Ballener
- Physical Therapist
- Ny, NY
National Provider Identifier
1710314984
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(3) exclusion effective Jun 19, 2025.
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 032523
- Practice address
- 824 55TH Street (Bet. 8TH & 9TH Ave.)
Brooklyn
Ny, NY 11220 - Phone
- (718) 686-1733
- NPI assigned
- Oct 3, 2013
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 032523 | NY | Primary |
Addresses
Primary practice location
824 55TH Street (Bet. 8TH & 9TH Ave.)
Brooklyn
Ny, NY 11220
Mailing address
64 Tuers Ave
#2C Jersey City
Jersey City, NJ 07306-3250
Phone (201) 850-0619
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032523 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380758400000",
"number": "1710314984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 TUERS AVE",
"address_2": "#2C JERSEY CITY",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073063250",
"telephone_number": "201-850-0619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "824 55TH STREET (BET. 8TH & 9TH AVE.)",
"address_2": "BROOKLYN",
"city": "NY",
"state": "NY",
"postal_code": "11220",
"telephone_number": "718-686-1733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLENER",
"first_name": "LYN",
"middle_name": "JONSON",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-03",
"last_updated": "2013-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "032523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ny, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.