Organization Active NPI

Lyons Medical PC

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1790225290
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LYONS MEDICAL PC
Practice address
45 Main St Ste 421
Brooklyn, NY 11201-1093
Phone
(718) 646-0427
Fax
(718) 616-1590
NPI assigned
Mar 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Authorized official

Name
John S Lyons, M.D.NPI 1972590438
Title
Director
Phone
(718) 872-5331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

45 Main St Ste 421
Brooklyn, NY 11201-1093

Mailing address

45 Main St Ste 421
Brooklyn, NY 11201-1093
Phone (718) 646-0427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170601001761 NY Part B Supplier - Clinic/Group Practice 3375810914 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY; Jackson Heights, NY

National Provider Directory

National Provider Directory

Locations

1733 Sheepshead Bay Rd
Ste 23
Brooklyn, NY 11235
Phone (718) 646-0427

1733 Sheepshead Bay Rd
Ste 29A
Brooklyn, NY 11235
Phone (718) 872-5331

45 Main St
Ste 421
Brooklyn, NY 11201
Phone (718) 646-0427

25 Central Park W
Apt 1M
New York, NY 10023
Phone (212) 315-3322

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1790225290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MAIN ST STE 421",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011093",
            "telephone_number": "718-646-0427",
            "fax_number": "718-616-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MAIN ST STE 421",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011093",
            "telephone_number": "718-646-0427",
            "fax_number": "718-616-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYONS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-02",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-872-5331",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.