Jessica Lauren Wyner, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017840 Issued in CA

Practice address

12660 Riverside Dr Ste 225
North Hollywood, CA 91607-3469

Phone

(818) 755-0265

NPI assigned

Aug 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Lauren Doctor Former name

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

Merit-based Incentive Payment System (MIPS)

Final score

80.57 of 100Reported as group

Quality

62.42

Promoting interoperability

76

Improvement activities

40

Cost

76.15

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.doctor.p1@direct.lakeside.nextgenshare.com

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.

• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1619643368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073429",
            "telephone_number": "818-755-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR STE 225",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073469",
            "telephone_number": "818-755-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNER",
        "first_name": "JESSICA",
        "middle_name": "LAUREN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DOCTOR",
            "middle_name": "LAUREN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Woodard
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• Wound Smart Health Group Inc
• Jessica Wright, IBCLC
• WSW MD Group Inc
• X-Ray Diagnostics Inc
• Denise Xavier, RDH, RDHAP
• Xpress Labs Inc
• Y&B Hospice Care, Inc.
• Dorly Isbeth Yac

• Family Nurse Practitioner in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.