Active NPI
Mason Lykes, TATTOO ARTIST
- Athletic Trainer
- New York, NY
National Provider Identifier
1962086686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 50107436
- Practice address
- 160 Madison Ave Ste 6
New York, NY 10016-5412 - Phone
- (929) 434-8004
- NPI assigned
- May 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Art Specialist/Technologist | 246ZA2600X | 50107436 | NY | |
| Clinic/Center | 261Q00000X | |||
| Technician | 374700000X | 50107436 | NY | |
| Athletic Trainer | 2255A2300X | 50107436 | NY | Primary |
Addresses
Primary practice location
160 Madison Ave Ste 6
New York, NY 10016-5412
Mailing address
167 Allen St Apt 2C
New York, NY 10002-2155
Phone (646) 331-2359
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@modernecosmetologie.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50107436 | NY | MD | Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620518400000",
"number": "1962086686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "167 ALLEN ST APT 2C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100022155",
"telephone_number": "646-331-2359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 MADISON AVE STE 6",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100165412",
"telephone_number": "929-434-8004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYKES",
"first_name": "MASON",
"credential": "TATTOO ARTIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-09",
"last_updated": "2021-05-09",
"certification_date": "2021-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "246ZA2600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Art, Medical",
"state": "NY",
"license": "50107436",
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": "NY",
"license": "50107436",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "50107436",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@modernecosmetologie.com",
"affiliation": "N",
"endpointDescription": "Business Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "160 Madison Ave Ste 6",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100165412",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.