Lyndsey Marie Alvut, AGPCNP
Individual provider Active NPI Primary Care Nurse Practitioner · San Diego, CA
NPI 1700568953 · NPPES record last updated Aug 7, 2023
Key facts
- NPI
- 1700568953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 95022165 (CA)
- Practice address
- 2629 Ocean Front Walk
San Diego, CA 92109-8242 - Phone
- (585) 301-5800
- NPI assigned
- Aug 7, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231024002005 | CA | Practitioner - Nurse Practitioner | 0446606610 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile Wound Care Physician Assistant Corporation | Current |
Accepting new patients |
Locations
4967 Newport Ave
#112241
San Diego, CA 92107
Phone (760) 492-4306
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 95022165 | CA | Yes |
Addresses
Primary practice location
2629 Ocean Front Walk
San Diego, CA 92109-8242
Mailing address
2629 Ocean Front Walk
San Diego, CA 92109-8242
Phone (585) 301-5800
Other providers in San Diego, CA
- Alexandra Lilja Alving-Trinh
- Providence M Alvira
- Lindsey Jaye Alvis
- Cassandra Alviz
- Carey Alvord
- Humam Alwan
- Mustafa Adam Alwash
- Eslam Alwi
- Manareteleslam Alyan
- Lisa Ann Alyea
All providers in San Diego, CA · Primary Care Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.