Individual provider Active NPI

Stephanie Lyulkin, NP

  • Family Nurse Practitioner
  • Chula Vista, CA
National Provider Identifier
1114793411
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023044 Issued in CA
Practice address
401 H St Ste 2
Chula Vista, CA 91910-4331
Phone
(858) 734-6475
NPI assigned
Nov 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95023044 CA Primary

Addresses

Primary practice location

401 H St Ste 2
Chula Vista, CA 91910-4331

Mailing address

13340 Violet LN
San Diego, CA 92130-6867

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419002565 CA Practitioner - Nurse Practitioner 3678912813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95023044CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monica Perlman MD Inc. CurrentSince Apr 29, 2024 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Locations

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

11865 Carmel Mountain Rd
Ste 1104
San Diego, CA 92128
Phone (858) 997-2583

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

9909 Mira Mesa Blvd
Ste 110
San Diego, CA 92131

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1114793411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13340 VIOLET LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 H ST STE 2",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104331",
            "telephone_number": "858-734-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYULKIN",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.