Individual provider Active NPI

Lori Lee Vanyo, MD

  • Surgery Physician
  • Pomona, CA
National Provider Identifier
1528036910
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A55042 Issued in CA
Practice address
1910 Royalty Dr
Pomona, CA 91767-3021
Phone
(909) 766-1600
Fax
(909) 766-1601
NPI assigned
Mar 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A55042 CA Primary

Addresses

Primary practice location

1910 Royalty Dr
Pomona, CA 91767-3021

Mailing address

1910 Royalty Dr
Pomona, CA 91767-3021
Phone (909) 766-1600

Other practice location 1

138 Harvard Ave
Claremont, CA 91711-4760
Phone (909) 624-4503

Other identifiers 1

IdentifierTypeStateIssuer
00A550420MedicaidCA

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
I20091027000768 CA Practitioner - General Surgery 5395769855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loma Linda University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1910 Royalty Dr
Pomona, CA 91767-3021
Phone (909) 766-1600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy25
Melanoma (skin cancer) excision17
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A55042CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lori L Vanyo MD Facs Inc Surgery CurrentSince Feb 8, 2018 Accepting new patients
Chaparral Medical Group, Inc. CurrentSince Jan 1, 2007 Accepting new patients
Chaparral Medical Group, Inc. Surgery Current Accepting new patients

Locations

2140 Grand Ave
Ste 120
Chino Hills, CA 91709
Phone (909) 392-2002

1910 Royalty Dr
Pomona, CA 91767
Phone (844) 400-2236

840 Towne Center Dr
Pomona, CA 91767

250 W Bonita Ave
Ste 100
Pomona, CA 91767
Phone (909) 392-2002

9190 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 581-6732

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGJEBD/Endpoint/IGJEBD

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1528036910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 ROYALTY DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673021",
            "telephone_number": "909-766-1600",
            "fax_number": "909-766-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 ROYALTY DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673021",
            "telephone_number": "909-766-1600",
            "fax_number": "909-766-1601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "138 Harvard Ave",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "CA",
            "postal_code": "917114760",
            "country_code": "US",
            "telephone_number": "909-624-4503",
            "fax_number": "909-624-6364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANYO",
        "first_name": "LORI",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A55042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A550420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.