Individual provider Active NPI

Christopher P Lombardo, MD

  • Otolaryngology Physician
  • Clearlake, CA
National Provider Identifier
1639111404
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G43247 Issued in CA
Practice address
15230 Lakeshore Dr
Clearlake, CA 95422-8107
Phone
(707) 995-4518
Fax
(707) 995-4526
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301101636 MI
Otolaryngology Physician 207Y00000X 036117548 IL
Otolaryngology Physician 207Y00000X G43247 CA Primary

Addresses

Primary practice location

15230 Lakeshore Dr
Clearlake, CA 95422-8107

Mailing address

15230 Lakeshore Dr
Clearlake, CA 95422-8107

Other identifiers 2

IdentifierTypeStateIssuer
036117548MedicaidIL
4632039OtherILBCBS

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
I20040609000632 CA Practitioner - Otolaryngology 7810970076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Southern California Keck School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15630 18TH Ave
Clearlake, CA 95422-9336
Phone (707) 994-6486

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.74 of 100Reported as group
Quality
94
Promoting interoperability
92
Improvement activities
40
Cost
65.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G43247CAMDOtolaryngology Physician
036117548ILMDOtolaryngology Physician
4301101636MIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Clearlake Hospital Inc. CurrentSince Jul 1, 2023 Accepting new patients
Elk River Physicians Group, PLLC Otolaryngology Past Accepting new patients
Adventist Health Clearlake Hospital, Inc Past Accepting new patients

Locations

15230 Lakeshore Dr
Clearlake, CA 95422
Phone (707) 995-4500

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

15322 Lakeshore Dr
Ste 102
Clearlake, CA 95422
Phone (707) 994-2030

18990 Coyote Valley Rd
Ste 8
Hidden Valley Lake, CA 95467
Phone (707) 987-8344

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 3

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1639111404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15230 LAKESHORE DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954228107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15230 LAKESHORE DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954228107",
            "telephone_number": "707-995-4518",
            "fax_number": "707-995-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBARDO",
        "first_name": "CHRISTOPHER",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301101636",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036117548",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G43247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117548",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4632039",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearlake, CA

Sources for this page

Verify at the official NPI Registry.