Individual provider Active NPI

Ellen Mary Lynch, MD

  • Pediatrics Physician
  • Lawrence, MA
National Provider Identifier
1982695805
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
78834 Issued in MA
Practice address
73D Winthrop Ave
Plaza 114
Lawrence, MA 01843-3716
Phone
(978) 686-3017
Fax
(978) 685-4280
NPI assigned
Oct 31, 2005
Last updated
Mar 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 78834 MA Primary

Addresses

Primary practice location

73D Winthrop Ave
Plaza 114
Lawrence, MA 01843-3716

Mailing address

73D Winthrop Ave
Plaza 114
Lawrence, MA 01843-3716
Phone (978) 686-3017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008000533 MA Practitioner - Pediatric Medicine 3173582772 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78834MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lawrence Family Health Center Inc CurrentSince Nov 7, 2015 Accepting new patients
Greater Lawrence Family Health Center, Inc. CurrentSince Nov 7, 2015 Accepting new patients

Locations

150 Park St
Lawrence, MA 01841
Phone (978) 685-1770

34 Haverhill St
Lawrence, MA 01841

73D Winthrop Ave
Lawrence, MA 01843
Phone (978) 686-3017

73D Winthrop Ave
#114
Lawrence, MA 01843
Phone (978) 686-3017

Interoperability endpoints

  • Direct secure messaging: ellen.lynch.1@23857.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1982695805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73D WINTHROP AVE",
            "address_2": "PLAZA 114",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018433716",
            "telephone_number": "978-686-3017",
            "fax_number": "978-685-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73D WINTHROP AVE",
            "address_2": "PLAZA 114",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018433716",
            "telephone_number": "978-686-3017",
            "fax_number": "978-685-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "ELLEN",
        "middle_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "78834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.