Individual provider Active NPI

Liset Stoletniy, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Loma Linda, CA
National Provider Identifier
1548295116
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
A51258 Issued in CA
Practice address
11234 Anderson St
#1617
Loma Linda, CA 92354-2804
Phone
(909) 558-8590
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A51258 CA
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X A51258 CA Primary

Addresses

Primary practice location

11234 Anderson St
#1617
Loma Linda, CA 92354-2804

Mailing address

File 54701
Los Angeles, CA 90074-4701
Phone (909) 558-8590

Other identifiers 1

IdentifierTypeStateIssuer
00A512580MedicaidCA

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
I20080619000635 CA Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8820169782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sac Health SystemGroup PAC ID 4385533579, 222 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

1454 E 2ND St
San Bernardino, CA 92408-0118
Phone (909) 382-7100

250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100

488 S K St
San Bernardino, CA 92410-2641
Phone (909) 383-8092

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

901 San Bernardino Rd
Suite 104And302
Upland, CA 91786-4912
Phone (909) 558-4000

File Number
Suite 54701
Los Angeles, CA 90074-4701

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
153461CAMDMarriage & Family Therapist
A51258CAMDAdvanced Heart Failure and Transplant Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System CurrentSince Aug 2, 2016 Accepting new patients
Sac Health System Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 1, 2009 Accepting new patients
Faculty Physicians and Surgeons of Llusm Cardiovascular Disease Current Accepting new patients
Sac Health System CurrentSince Aug 2, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Jan 1, 2009 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
Desert Valley Hospital, LLC Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11234 Anderson St
#1617
Loma Linda, CA 92350
Phone (909) 558-4200

11234 Anderson St
Fl 7
Loma Linda, CA 92350

11234 Anderson St
Ste 1617
Loma Linda, CA 92350
Phone (909) 558-2848

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

11234 Anderson St
Fl 6
Loma Linda, CA 92350

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

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

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

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

1003 E Brier Dr
San Bernardino, CA 92408

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

399 E 21st St
Sn Bernrdno, CA 92404
Phone (909) 882-2266

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lstoletniy11441@direct.llu.edu

Organizations & group practices 10

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1548295116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 54701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-558-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "#1617",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLETNIY",
        "first_name": "LISET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A51258",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "CA",
            "license": "A51258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A512580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.