Individual provider Active NPI

Lyndsey Bauer, PHD

  • Clinical Neuropsychologist
  • Utica, NY
National Provider Identifier
1790910545
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
68018042 Issued in NY
Practice address
1656 Champlin Ave
Utica, NY 13502-4830
Phone
(315) 624-4101
Fax
(315) 624-4105
NPI assigned
May 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 68018042 NY Primary

Addresses

Primary practice location

1656 Champlin Ave
Utica, NY 13502-4830

Mailing address

1656 Champlin Ave
Utica, NY 13502-4830
Phone (315) 624-4101

Other identifiers 1

IdentifierTypeStateIssuer
03318421MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140321000757 NY Practitioner - Clinical Psychologist 3173787801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

8411 Seneca Tpke
New Hartford, NY 13413-4912
Phone (315) 624-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
68018042NYMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Jan 7, 2013 Accepting new patients
MVHS Inc CurrentSince Jan 7, 2013 Accepting new patients

Locations

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

1656 Champlin Ave
Utica, NY 13502
Phone (315) 624-6241

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1790910545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024830",
            "telephone_number": "315-624-4101",
            "fax_number": "315-624-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024830",
            "telephone_number": "315-624-4101",
            "fax_number": "315-624-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "LYNDSEY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "68018042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03318421",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.