Individual provider Active NPI

Haley M Lynn

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1871102202
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
310474 Issued in NY
Practice address
318 Knickerbocker Ave
Brooklyn, NY 11237-3888
Phone
(718) 765-6056
NPI assigned
Jul 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 9052 CT
Adult Health Nurse Practitioner 363LA2200X 310474 NY Primary

Addresses

Primary practice location

318 Knickerbocker Ave
Brooklyn, NY 11237-3888

Mailing address

PO Box 746087
Atlanta, GA 30374-6087
Phone (312) 733-9730

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
I20211213002336 NY Practitioner - Nurse Practitioner 3971993577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Myers Medical PCGroup PAC ID 5294145017, 78 clinicians

Practice addresses (Care Compare)

318 Knickerbocker Ave
Brooklyn, NY 11237-3888
Phone (718) 765-6056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
310474NYMDLicensed Practical Nurse
9052CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Griffin Myers Medical, P.C. CurrentSince Sep 27, 2021 Accepting new patients

Locations

455 Sutter Ave
Brooklyn, NY 11212
Phone (718) 765-6550

11515 Sutphin Blvd
Jamaica, NY 11434
Phone (718) 659-4000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: haley.lynn@oakstreethealth.gwaydirect.com

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1871102202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373888",
            "telephone_number": "718-765-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "HALEY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2024-11-12",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "9052",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.