JACK TYLER LYDEN MD
NPI 1346980919
Psychiatry & Neurology - Psychiatry in Corona, CA

Active since March 31, 2022PECOS EnrolledAccepts Medicare Assignment
4160 TEMESCAL CANYON RD, CORONA, CA 92883(858) 279-1223 Get Directions Write a Review

NPPES record last updated: May 8, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jack Tyler Lyden Md NPPES

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

JACK TYLER LYDEN MD (NPI 1346980919) is an individual psychiatry provider in Corona, California, licensed in California (209112) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of University Of South Florida College Of Medicine (2022).

NPPES Registry Identity

NPI1346980919
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameJACK TYLER LYDENCredential: MD
Location Address4160 TEMESCAL CANYON RDCorona, CA 92883-4625
Mailing Address4160 Temescal Canyon RdCorona, CA 92883-4625
Sole ProprietorNo
Medical School CMSUniversity Of South Florida College Of MedicineGraduated 2022
Enumeration DateMarch 31, 2022
Last NPPES UpdateMay 8, 2026
NPPES CertifiedMay 8, 2026
✔ NPI 1346980919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in CA · 209112
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
4160 TEMESCAL CANYON RD, Corona, CA 92883

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack Tyler Lyden Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810469848
PECOS Enrollment IDI20260610003884
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.

Medicare Billing Reassignment

Medicare enrollment records show Jack Lyden reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Clinical
7373 N SCOTTSDALE RD STE A199
Scottsdale, AZ 85253
  • Reassigned Medicare billing, California enrollment
  • 766 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92883 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$179.42 typical visit price
range $59.60 – $179.42
Typical copayment $44.85 (range $14.90 – $44.85)
Most-billed visit code 99205
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

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

Psychologist (Clinical)
4160 TEMESCAL CANYON RD, ST 309
CORONA, CA 92883
Psychologist (Clinical)
4160 TEMESCAL CANYON RD, SUITE 309
CORONA, CA 92883
Social Worker (Clinical)
4160 TEMESCAL CANYON RD
CORONA, CA 92883
Marriage & Family Therapist
4160 TEMESCAL CANYON RD, SUITE 309
CORONA, CA 92883
Marriage & Family Therapist
4160 TEMESCAL CANYON RD
CORONA, CA 92883

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Lyden's NPI number?

The NPI number for Jack Lyden is 1346980919. It was assigned to this individual provider in the NPPES registry on March 31, 2022.

Where is Jack Lyden located?

Jack Lyden practices at 4160 Temescal Canyon Rd, Corona, CA 92883. The listed phone number is (858) 279-1223.

What is Jack Lyden's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Jack Lyden enrolled in Medicare?

Yes. Jack Lyden is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jack Lyden's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Lyden reassigns Medicare benefits to Pacific Coast Psychiatric Associates Inc (Scottsdale, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Lyden's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jack Lyden was last updated on May 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.