Individual provider Active NPI

Christine Suzanne Lundstedt, FNP-C

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1376016048
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11009616 Issued in FL
Practice address
5395 Ruffin Rd Ste 204
San Diego, CA 92123-1338
Phone
(858) 571-3630
Fax
(858) 430-3146
NPI assigned
Jan 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009138 CA
Family Nurse Practitioner 363LF0000X 11009616 FL Primary

Addresses

Primary practice location

5395 Ruffin Rd Ste 204
San Diego, CA 92123-1338

Mailing address

200 S Park Rd Ste 200
Hollywood, FL 33021-8541
Phone (866) 986-2263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190426000870 CA Practitioner - Nurse Practitioner 3577805365 Reassigns benefits to 1 organization
I20210104000620 FL Practitioner - Nurse Practitioner 3577805365 Reassigns benefits to 1 organization
I20241030002922 TN Practitioner - Nurse Practitioner 3577805365

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11009616FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John Qian M.D. Inc. CurrentSince May 1, 2019 Accepting new patients
Chma of FL, PLLC CurrentSince Sep 19, 2022 Accepting new patients
John Qian M.D. Inc. CurrentSince May 1, 2019 Accepting new patients
Home Physicians Medical Group, Inc. CurrentSince Jan 28, 2019 Accepting new patients

Locations

4849 Ronson Ct
Ste 217
San Diego, CA 92111
Phone (858) 279-1212

5395 Ruffin Rd
Ste 204
San Diego, CA 92123

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

909 Ridgebrook Rd
Ste 300
Sparks Glencoe, MD 21152
Phone (443) 483-9300

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/10731/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1546732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1376016048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S PARK RD STE 200",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218541",
            "telephone_number": "866-986-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5395 RUFFIN RD STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231338",
            "telephone_number": "858-571-3630",
            "fax_number": "858-430-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDSTEDT",
        "first_name": "CHRISTINE",
        "middle_name": "SUZANNE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-06",
        "last_updated": "2022-08-19",
        "certification_date": "2022-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009138",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11009616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.