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ELYSE WYATT
NPI 1417623604
Student in an Organized Health Care Education/Training Program in Lebanon, NH

Active since August 18, 2021PECOS Enrolled
1 MEDICAL DR, LEBANON, NH 03756(603) 650-5000 Get Directions Write a Review

NPPES record last updated: March 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 27, 2025, Aug 18, 2021 (2 updates tracked since 2021).

About Elyse Wyatt NPPES

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

ELYSE WYATT (NPI 1417623604) is an individual student in an organized health care education/training program in Lebanon, New Hampshire and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417623604
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameELYSE WYATT
Location Address1 MEDICAL DRLebanon, NH 03756-1000
Mailing Address1 Medical DrLebanon, NH 03756-1000 · (603) 650-5000
Phone(603) 650-5000
Sole ProprietorNo
Enumeration DateAugust 18, 2021
Last NPPES UpdateMarch 27, 20252 updates tracked since enumeration
NPPES CertifiedMarch 27, 2025
✔ NPI 1417623604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1 MEDICAL DR, Lebanon, NH 03756
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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)

Elyse Wyatt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 20

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

EMILY L SWANN APRN
Nurse Practitioner
1 MEDICAL DR
LEBANON, NH 03756
Grafton County (603) 650-6224
DR. JESSICA MARGARET SIN M.D., PH.D.
Radiology (Diagnostic Radiology)
1 MEDICAL DR
LEBANON, NH 03756
Grafton County (603) 650-7650
MR. JUSTIN BERNARD MONTGOMERY FNP-C
Nurse Practitioner (Family)
1 MEDICAL DR, ATTN CENTERS FOR HEALTHY AGING
LEBANON, NH 03756
Grafton County (603) 650-5000
MICHELLE GAFFNEY LAIN MD, MS
Student in an Organized Health Care Education/Training Program
1 MEDICAL DR
LEBANON, NH 03756
Grafton County (603) 650-5000
JENNIFER ANNE POPIES AGACNP-BC, ACNS-BC
Nurse Practitioner (Adult Health)
1 MEDICAL DR
LEBANON, NH 03756
Grafton County (603) 650-5000
ILYA NIKOLAEVICH BOYKOV MD
Student in an Organized Health Care Education/Training Program
1 MEDICAL DR
LEBANON, NH 03756
Grafton County (603) 650-5000
XAVIER FOWLER
Student in an Organized Health Care Education/Training Program
1 MEDICAL DR
LEBANON, NH 03756
Grafton County (845) 893-2210
NATALIE NICHOLE ROBERTSON MD
Student in an Organized Health Care Education/Training Program
1 MEDICAL DR
LEBANON, NH 03756
Grafton County (603) 650-5000

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 Elyse Wyatt's NPI number?

The NPI number for Elyse Wyatt is 1417623604. It was assigned to this individual provider in the NPPES registry on August 18, 2021.

Where is Elyse Wyatt located?

Elyse Wyatt practices at 1 Medical Dr, Lebanon, NH 03756. The listed phone number is (603) 650-5000.

What is Elyse Wyatt's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Elyse Wyatt enrolled in Medicare?

Yes. Elyse Wyatt is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Elyse Wyatt was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.