Individual provider Active NPI

Lynn M Keppel, PA

  • Physician Assistant
  • New York City, NY
National Provider Identifier
1770554206
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009505 Issued in NY
Practice address
205 E 64 St
Suite 402
New York City, NY 10021
Phone
(212) 759-4553
Fax
(212) 486-8334
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009505 NY Primary

Addresses

Primary practice location

205 E 64 St
Suite 402
New York City, NY 10021

Mailing address

205 E 64 St
Suite 402
New York City, NY 10021
Phone (212) 759-4553

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050318000899 NY Practitioner - Physician Assistant 7416902788 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
009505NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics Spine and Sports Medicine LLC CurrentSince Feb 15, 2019 Accepting new patients
Orthopaedics Spine and Sports Medicine, LLC Current Accepting new patients
Orthopaedics Spine and Sports Medicine LLC CurrentSince Feb 15, 2019 Accepting new patients
Lenox Hill Radiology & Medical Imaging Associates, PC Past Accepting new patients

Locations

2510 Westchester Ave
Ste 100
Bronx, NY 10461
Phone (718) 684-4677

1789 Sheepshead Bay Rd
Brooklyn, NY 11235
Phone (347) 587-1049

2103 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-4500

2339 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 520-3053

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

12 Unqua Rd
Massapequa, NY 11758

5500 Merrick Rd
Massapequa, NY 11758
Phone (516) 797-2657

115 Eileen Way
Syosset, NY 11791
Phone (516) 622-9797

Interoperability endpoints

  • Direct secure messaging: lynnkeppel@ossm.allscriptsdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1770554206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E 64 ST",
            "address_2": "SUITE 402",
            "city": "NEW YORK CITY",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-759-4553",
            "fax_number": "212-486-8334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E 64 ST",
            "address_2": "SUITE 402",
            "city": "NEW YORK CITY",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-759-4553",
            "fax_number": "212-486-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPPEL",
        "first_name": "LYNN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York City, NY

Sources for this page

Verify at the official NPI Registry.