Individual provider Active NPI

Lorraine Reverson Ray

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1295179620
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
150249 Issued in CA
Practice address
25845 Barton Rd
Loma Linda, CA 92354-3899
Phone
(909) 558-2828
NPI assigned
Apr 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 150249 CA
Pediatrics Physician 208000000X 150249 CA Primary

Addresses

Primary practice location

25845 Barton Rd
Loma Linda, CA 92354-3899

Mailing address

54701 File Number
Los Angeles, CA 90074-4701
Phone (909) 651-4300

Other practice location 1

740 S Limestone St
Lexington, KY 40536-0284
Phone (859) 323-6561

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
I20170823003405 CA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 3577875830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Loma Linda University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11370 Anderson St
Loma Linda, CA 92354-3450

11441 Heacock St
Suite C
Moreno Valley, CA 92557-7907
Phone (951) 247-5809

7223 Church St
Suite C1
Highland, CA 92346-5869
Phone (909) 425-3946

81 Highland Springs Ave
Beaumont, CA 92223-3170
Phone (909) 558-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
150249CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 1, 2017 Accepting new patients
Sac Health System Current Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697

11441 Heacock St
Ste C
Moreno Valley, CA 92557
Phone (951) 247-5809

26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Interoperability endpoints

  • Direct secure messaging: lray137124@direct.llu.edu

Organizations & group practices 11

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": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295179620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-651-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25845 BARTON RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543899",
            "telephone_number": "909-558-2828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 S Limestone St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360284",
            "country_code": "US",
            "telephone_number": "859-323-6561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "LORRAINE",
        "middle_name": "REVERSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "150249",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "150249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.