Individual provider Active NPI

Tina Suzanne Lennon, MD

  • Anesthesiology Physician
  • Apple Valley, CA
National Provider Identifier
1528240389
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
NONE Issued in NY
Practice address
15836 Saint Timothy Rd
Apple Valley, CA 92307-2517
Phone
(914) 843-4008
NPI assigned
Dec 3, 2007
Last updated
Oct 22, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NONE NY Primary

Addresses

Primary practice location

15836 Saint Timothy Rd
Apple Valley, CA 92307-2517

Mailing address

15836 Saint Timothy Rd
Apple Valley, CA 92307-2517
Phone (914) 843-4008

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
I20101014000159 CA Practitioner - Anesthesiology 8628260254 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York Medical College, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coachella Valley Anesthesia a Professional CorporationGroup PAC ID 5698131969, 126 clinicians

Practice addresses (Care Compare)

420 34TH St
Bakersfield, CA 93301-2237
Phone (661) 324-4647

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NONENYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Coachella Valley Anesthesia a Professional Corporation Anesthesiology CurrentSince May 1, 2024 Accepting new patients
Landmark Anesthesia Medical Group Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients
Bairos Nursing Anesthesia,Inc CurrentSince May 12, 2018 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

900 E Washington St
Ste 155
Colton, CA 92324
Phone (909) 370-2190

700 W El Norte Pkwy
Escondido, CA 92026
Phone (760) 738-7830

2271 W Malvern Ave
Fullerton, CA 92833
Phone (562) 773-4243

555 E Hardy St
Inglewood, CA 90301
Phone (310) 419-8636

5 Holland
Ste 101
Irvine, CA 92618
Phone (949) 588-2199

6601 White Feather Rd
Joshua Tree, CA 92252
Phone (760) 366-1500

28062 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

44139 Monterey Ave
Ste B
Palm Desert, CA 92260
Phone (760) 773-4411

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1528240389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15836 SAINT TIMOTHY RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072517",
            "telephone_number": "914-843-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15836 SAINT TIMOTHY RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072517",
            "telephone_number": "914-843-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENNON",
        "first_name": "TINA",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "NONE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.