Individual provider Active NPI

Lacy Jay Nasseh, FNP

  • Family Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1255054631
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95120763 Issued in CA
Practice address
2255 Ygnacio Valley Rd Ste T35
Walnut Creek, CA 94598-3343
Phone
(925) 681-9246
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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 95120763 CA Primary

Addresses

Primary practice location

2255 Ygnacio Valley Rd Ste T35
Walnut Creek, CA 94598-3343

Mailing address

2255 Ygnacio Valley Rd Ste T
Walnut Creek, CA 94598-3343
Phone (925) 954-8209

Other names 1

  • Lacy Jay Martin Former name

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
I20230427001747 CA Practitioner - Nurse Practitioner 4486019346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bass Medical GroupGroup PAC ID 9032111281, 292 clinicians

Practice addresses (Care Compare)

1505 Saint Alphonsus Way
Alamo, CA 94507-1570
Phone (925) 932-6330

2637 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone (925) 378-4512

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95120763CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group Current Accepting new patients
Bass Medical Group CurrentSince Jan 17, 2023 Accepting new patients
Bass Medical Group CurrentSince Jan 17, 2023 Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

2255 Ygnacio Valley Rd
Ste T
Walnut Creek, CA 94598
Phone (925) 289-1808

Interoperability endpoints

  • Direct secure messaging: lnasseh162520@ehr.johnmuirhealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IBDGCA

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1255054631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD STE T",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983343",
            "telephone_number": "925-954-8209",
            "fax_number": "925-891-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD STE T35",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983343",
            "telephone_number": "925-681-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSEH",
        "first_name": "LACY",
        "middle_name": "JAY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95120763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACY",
            "last_name": "MARTIN",
            "middle_name": "JAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.