Individual provider Active NPI

Lynette S Ensminger, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1548447345
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
NP1997 Issued in CA
Practice address
1409 E Briggsmore Ave
Modesto, CA 95355-2707
Phone
(209) 550-4720
NPI assigned
Jan 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN314733 CA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X NP1997 CA Primary

Addresses

Primary practice location

1409 E Briggsmore Ave
Modesto, CA 95355-2707

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097

Other identifiers 1

IdentifierTypeStateIssuer
RN314733MedicaidCA

Other names 1

  • Lynette Tobler Former name

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
I20050103000248 CA Practitioner - Nurse Practitioner 7618935008 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN314733CAMDRegistered Nurse
1997CAMDPsychiatric/Mental Health Registered Nurse
NP1997CAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Mar 1, 2016 Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Mar 1, 2016 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2516 E Whitmore Ave
Ceres, CA 95307
Phone (209) 538-1733

1011 Sylvan Ave
Ste C
Modesto, CA 95350
Phone (209) 550-4740

1409 E Briggsmore Ave
Spc Ctr
Modesto, CA 95355

1144 Coffee Rd
Modesto, CA 95355
Phone (209) 524-0370

1409 E Briggsmore Ave
Modesto, CA 95355
Phone (209) 550-4725

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

3612 Dale Rd
Modesto, CA 95356
Phone (209) 522-0146

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: lensminger26949@hisp.ehr.sutterhealth.org

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": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1548447345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E BRIGGSMORE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552707",
            "telephone_number": "209-550-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENSMINGER",
        "first_name": "LYNETTE",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-24",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN314733",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "NP1997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN314733",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNETTE",
            "last_name": "TOBLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.