LYDIA HOGAN PSYD
NPI 1205428174
Clinical Neuropsychologist in Portland, OR

Q: What is Lydia Hogan's NPI number?

The NPI number for Lydia Hogan is 1205428174. It was assigned to this individual provider in the NPPES registry on February 10, 2021.

Q: What is Lydia Hogan's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Lydia Hogan was last updated on April 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 10, 2021PECOS Enrolled

4640 S MACADAM AVE STE 90, PORTLAND, OR 97239(503) 292-0765 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 3, 2026, Jan 12, 2026, Dec 30, 2025 and 1 more (4 updates tracked since 2021).

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About Lydia Hogan Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LYDIA HOGAN PSYD (NPI 1205428174) is an individual clinical neuropsychologist in Portland, Oregon, licensed in Oregon (4122) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1205428174

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameLYDIA HOGANCredential: PSYD

Location Address4640 S MACADAM AVE STE 90Portland, OR 97239-4285

Mailing Address14490 Se Wy East AveDamascus, OR 97089-7817 · (971) 221-0940

Phone(503) 292-0765

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateFebruary 10, 2021

Last NPPES UpdateApril 3, 20264 updates tracked since enumeration

NPPES CertifiedApril 3, 2026

✔ NPI 1205428174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in OR · 4122

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 4122 (OR)

4640 S MACADAM AVE STE 90, Portland, OR 97239

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lydia Hogan Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4981184678

PECOS Enrollment IDI20260212001996

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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