Andre P. Lallande, D.O.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

20A7021 Issued in CA

Practice address

5726 Ridgemark PL
Fontana, CA 92336-5159

Phone

(909) 559-1050

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Andre P. Lallande Professional name

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

Specialty

Family Practice

Education

College of Osteo Med of the Pacific at Pomona, 1995

Medicare assignment

May accept Medicare assignment

Group practices

Lake County Tribal Health Consortium IncGroup PAC ID 8729975545, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andre.lallande.p1@direct.lcthc.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lake County Tribal Health Consortium Inc.

  • Federally Qualified Health Center (FQHC)
  • Lakeport, CA
  • NPI 1881697381
  Medicare reassignment Care Compare group NPD
• Lake County Tribal Health Southshore Clinic

  • Federally Qualified Health Center (FQHC)
  • Clearlake, CA
  • NPI 1063158038
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health Clearlake Hospital Inc.

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Care Compare affiliation

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1053471045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5726 RIDGEMARK PL",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365159",
            "telephone_number": "909-559-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5726 RIDGEMARK PL",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365159",
            "telephone_number": "909-559-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALLANDE",
        "first_name": "ANDRE",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A7021",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "20A7021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA # FOR GROUP",
            "identifier": "05D0575313",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "ZZZ34392Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDRE",
            "last_name": "LALLANDE",
            "middle_name": "P.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Seven Lee Lakey
• Michelle Laksana, PA-C
• Victor Hugo Lalama, D.C.
• Manouchehr Lalehzarian, MD
• Simon P Lalehzarian, MD, MHA, MS
• Chris V Lam, PA
• Kayla Lam
• Vicky Munwah Lam, PHARM.D.
• Mark Jonathan Landau, M.D., PH.D.
• Levin Alexander Gamaliel Landaverde Ventura Jr.

• Rheumatology Physician in Fontana, CA
• Providers in Fontana, CA by specialty
• Rheumatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.