Individual provider Active NPI

Jay Robert Lentzner, M.D.

  • Psychiatry Physician
  • Long Beach, CA
National Provider Identifier
1982884904
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A93210 Issued in CA
Practice address
1630 Park Ave Apt 5
Long Beach, CA 90815-3869
Phone
(562) 597-1859
Fax
(562) 597-8210
NPI assigned
Nov 7, 2007
Last updated
Aug 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A93210 CA Primary

Addresses

Primary practice location

1630 Park Ave Apt 5
Long Beach, CA 90815-3869

Mailing address

1630 Park Ave Apt 5
Long Beach, CA 90815-3869
Phone (562) 597-1859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090210000730 CA Practitioner - Psychiatry 3173688041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albany Medical College of Union University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Roads Foundation, IncGroup PAC ID 2961722558, 57 clinicians

Practice addresses (Care Compare)

121 S Long Beach Blvd
Compton, CA 90221-3423
Phone (310) 627-5850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93210CAMDPsychiatry Physician
93210CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Roads Foundation, Inc. Psychiatry CurrentSince Oct 1, 2022 Accepting new patients
The Roads Foundation, Inc CurrentSince Oct 1, 2022 Accepting new patients
The Department of Psychiatry Psychiatry CurrentSince Oct 1, 2008 Accepting new patients

Locations

121 S Long Beach Blvd
Compton, CA 90221
Phone (310) 627-5850

4525 E Atherton St
Long Beach, CA 90815
Phone (562) 961-0155

4525 E Atherton St
Fl 2
Long Beach, CA 90815
Phone (562) 422-2240

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAD

Organizations & group practices 3

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": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1982884904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 PARK AVE APT 5",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153869",
            "telephone_number": "562-597-1859",
            "fax_number": "562-597-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 PARK AVE APT 5",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153869",
            "telephone_number": "562-597-1859",
            "fax_number": "562-597-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENTZNER",
        "first_name": "JAY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A93210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.