Individual provider Active NPI

Kristopher Lyon, M.D.

  • Emergency Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1114131489
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A100746 Issued in CA
Practice address
283 Madonna Rd Ste B
San Luis Obispo, CA 93405-5432
Phone
(805) 549-8880
Fax
(805) 783-2009
NPI assigned
May 9, 2007
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A100746 CA Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X A100746 CA

Addresses

Primary practice location

283 Madonna Rd Ste B
San Luis Obispo, CA 93405-5432

Mailing address

283 Madonna Rd Ste B
San Luis Obispo, CA 93405-5432
Phone (805) 549-8880

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090723000740 CA Practitioner - Emergency Medicine 2062564941 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of KernGroup PAC ID 7810887205, 75 clinicians
Med-Stops Medical Clinic IncGroup PAC ID 9537073242, 3 clinicians

Practice addresses (Care Compare)

1800 Mount Vernon Ave
Bakersfield, CA 93306-3302
Phone (661) 321-3000

283 Madonna Rd
Suite B
San Luis Obispo, CA 93405-5432
Phone (805) 549-8880

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
82.65
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.65
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Education

State licenses

LicenseStateTypeSpecialty
A100746CAMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Multi-Specialty Current Accepting new patients
Med-Stops Medical Clinic, Inc. Multi-Specialty CurrentSince May 1, 2015 Accepting new patients
Cep America - California Multi-Specialty CurrentSince Nov 1, 2012 Accepting new patients
Cep America-California Multi-Specialty CurrentSince Nov 1, 2012 Accepting new patients
Sunshine Physician Services, PC Multi-Specialty CurrentSince Jan 8, 2024 Accepting new patients
Grand Avenue Emergency Physicians Medical Group Inc Multi-Specialty CurrentSince Aug 28, 2023 Accepting new patients

Locations

1025 S Anaheim Blvd
Anaheim, CA 92805
Phone (714) 533-6220

345 S Halcyon Rd
Arroyo Grande, CA 93420
Phone (805) 489-4261

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

751 Medical Center Ct
#1182
Chula Vista, CA 91911

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1911 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 542-6633

283 Madonna Rd
Ste B
Sn Luis Obisp, CA 93405
Phone (805) 549-8880

1100 Magellan Dr
Tehachapi, CA 93561
Phone (661) 823-3000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1114131489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 MADONNA RD STE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055432",
            "telephone_number": "805-549-8880",
            "fax_number": "805-783-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 MADONNA RD STE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055432",
            "telephone_number": "805-549-8880",
            "fax_number": "805-783-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "KRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A100746",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "A100746",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.