Active NPI
Lars Mikael Stensman, M.D.
- Pediatrics Physician
- Alpine, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A158569
- Practice address
- 1620 Alpine Blvd Ste 116
Alpine, CA 91901-1103 - Phone
- (619) 662-4100
- NPI assigned
- Apr 23, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MED-PHYS-LIC-41023 | MT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 0116024330 | VA | |
| Pediatrics Physician | 208000000X | A158569 | CA | Primary |
Addresses
Primary practice location
1620 Alpine Blvd Ste 116
Alpine, CA 91901-1103
Mailing address
1620 Alpine Blvd Ste 116
Alpine, CA 91901-1103
Phone (619) 662-4100
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MED-PHYS-LIC-41023 | MT | MD | Pediatrics Physician |
| A158569 | CA | MD | Psychiatry Physician |
| 0116024330 | VA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud de la Comunidad de San Ysidro Inc | Current | Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current | Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current | Accepting new patients | |
| Rady Children'S Hospital San Diego | Past | Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Past | Accepting new patients |
Locations
1620 Alpine Blvd
Ste 110
Alpine, CA 91901
Phone (760) 350-9725
1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780
1136 D Ave
National City, CA 91950
Phone (619) 336-2300
4050 Beyer Blvd
San Ysidro, CA 92173
120 Town Center Pkwy
Santee, CA 92071
Phone (619) 645-0111
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- lstensman18803@syhealth.direct-ci.com
Organizations & group practices 5
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.
-
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1124782685
-
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1457033813
-
- Federally Qualified Health Center (FQHC)
- National City, CA
- NPI 1598907487
-
- Federally Qualified Health Center (FQHC)
- National City, CA
- NPI 1003869363
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Diego, CA
- NPI 1851303994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652659200000",
"number": "1659638062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 ALPINE BLVD STE 116",
"city": "ALPINE",
"state": "CA",
"postal_code": "919011103",
"telephone_number": "619-662-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 ALPINE BLVD STE 116",
"city": "ALPINE",
"state": "CA",
"postal_code": "919011103",
"telephone_number": "619-662-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STENSMAN",
"first_name": "LARS",
"middle_name": "MIKAEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-23",
"last_updated": "2022-05-16",
"certification_date": "2022-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MT",
"license": "MED-PHYS-LIC-41023",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0116024330",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A158569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alpine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.