Lydia Kay Wilson, GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

513626 Issued in CA

Practice address

18855 Victory Blvd
Attn: Billing Department
Reseda, CA 91335-6445

Phone

(818) 774-3354

Fax

(818) 757-4401

NPI assigned

Jul 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Romeo L Isidro MD IncGroup PAC ID 1052481215, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.55 of 100Reported as group

Quality

95

Improvement activities

40

Cost

45.16

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lydia.wilson.p1@direct.lakeside.nextgenshare.com

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.

• Romeo L Isidro, MD, Inc

  • Psychiatry Physician
  • Northridge, CA
  • NPI 1467484576
  Medicare reassignment Care Compare group NPD
• GN Medical Associates, Inc.

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1275576522

  Gerontology

  Medicare reassignment NPD
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  Medicare reassignment NPD

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093729824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "STE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255408",
            "telephone_number": "818-368-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18855 VICTORY BLVD",
            "address_2": "ATTN: BILLING DEPARTMENT",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913356445",
            "telephone_number": "818-774-3354",
            "fax_number": "818-757-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LYDIA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-03-07",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "513626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N.P. FURNISHING",
            "identifier": "11725",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "513626",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00705925",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilbur Sleep Center
• Wilbur Sleeping Center Inc
• William Roberts Marriage & Family Therapist, Professional Corporation
• David Williams, PT, DPT
• Kandis Williams
• Melissa Ann Wilson, PTA
• Helen L Wong, PTA
• Richie Phu Wong, PSY.D.
• Woodland Care Center, LLC
• World Medical Supply Inc

• Gerontology Nurse Practitioner in Reseda, CA
• Providers in Reseda, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.