Individual provider Active NPI

Lindsey Machicote, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1851769889
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY022729 Issued in NY
Practice address
406 10TH Ave
New York, NY 10001-2320
Phone
(212) 273-6500
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 022729 NY
Clinical Child & Adolescent Psychologist 103TC2200X PSB94021918 CA
School Psychologist 103TS0200X
Clinical Psychologist 103TC0700X PSY022729 NY Primary

Addresses

Primary practice location

406 10TH Ave
New York, NY 10001-2320

Mailing address

406 10TH Ave
New York, NY 10001-2320
Phone (212) 273-6500

Other practice location 1

3443 W Shaw Ave
Fresno, CA 93711-3249
Phone (559) 271-1186

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
I20181023002462 NY Practitioner - Clinical Psychologist 4688927510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Young Adult Institute IncGroup PAC ID 1153216353, 28 clinicians

Practice addresses (Care Compare)

21111 Northern Blvd
Bayside, NY 11361-3241
Phone (212) 563-7474

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY022729NYMDClinical Psychologist
PSB94021918CAMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Young Adult Institute, Inc. CurrentSince Sep 2, 2018 Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

220 E 42nd St
Fl 8
New York, NY 10017
Phone (212) 273-2761

Organizations & group practices 1

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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1851769889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012320",
            "telephone_number": "212-273-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012320",
            "telephone_number": "212-273-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3443 W Shaw Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937113249",
            "country_code": "US",
            "telephone_number": "559-271-1186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACHICOTE",
        "first_name": "LINDSEY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022729",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSB94021918",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "PSY022729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.