Individual provider Active NPI

Leslie Ann Lyda, NP

  • Acute Care Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1417263070
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
19988 Issued in CA
Practice address
2315 Stockton Blvd Ste 1621
Sacramento, CA 95817-2201
Phone
(916) 325-1040
NPI assigned
Aug 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 19988 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd Ste 1621
Sacramento, CA 95817-2201

Mailing address

2315 Stockton Blvd Ste 1621
Sacramento, CA 95817-2201
Phone (916) 734-2011

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
I20150928002666 CA Practitioner - Nurse Practitioner 0749598555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4001 J St
Sacramento, CA 95819-3626
Phone (916) 453-4545

6501 Coyle Ave
Carmichael, CA 95608-0306
Phone (916) 537-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19988CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Mar 11, 2018 Accepting new patients
Acute Care Surgery Medical Group, Inc. CurrentSince Jul 8, 2015 Accepting new patients

Locations

6501 Coyle Ave
Carmichael, CA 95608
Phone (916) 537-5000

6555 Coyle Ave
Ste 220
Carmichael, CA 95608
Phone (916) 241-9677

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

77 Cadillac Dr
Sacramento, CA 95825
Phone (916) 734-3456

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

2315 Stockton Blvd
Ste 1621
Sacramento, CA 95817
Phone (916) 325-1040

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2315 Stockton Blvd
Ste 1200
Sacramento, CA 95817
Phone (916) 734-5394

1800 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 252-2225

Organizations & group practices 3

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1417263070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD STE 1621",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD STE 1621",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-325-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDA",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "19988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.