Individual provider Active NPI

Leandra Lyon, DO

  • Family Medicine Physician
  • Grass Valley, CA
National Provider Identifier
1790281053
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A17756 Issued in CA
Practice address
10058 Wolf Rd
Grass Valley, CA 95949-8194
Phone
(530) 745-1500
NPI assigned
Apr 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 17756 CA
Family Medicine Physician 207Q00000X 20A17756 CA Primary

Addresses

Primary practice location

10058 Wolf Rd
Grass Valley, CA 95949-8194

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Other practice location 1

155 N Fresno St
Fresno, CA 93701-2302
Phone (559) 499-6450

Other names 1

  • Dr. Leandra Conley 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210714001947 CA Practitioner - Family Practice 6709288640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

10058 Wolf Rd
Grass Valley, CA 95949-8194
Phone (530) 268-0847

2 Medical Plaza Dr
Roseville, CA 95661-3042

2800 L St
Sacramento, CA 95816-5616

3288 Bell Rd
Auburn, CA 95603-9243
Phone (530) 886-2300

3320 Bell Rd
Auburn, CA 95603-9243
Phone (530) 888-1266

Hospital & facility affiliations

  • Sutter Auburn Faith Vna & Hospice Home health agency, Auburn, CA, CCN 557292
  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A17756CAMDFamily Medicine Physician
17756CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 1, 2021 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

10058 Wolf Rd
Grass Valley, CA 95949
Phone (530) 268-0847

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

2951 Benefit Way
Sacramento, CA 95834
Phone (916) 285-8100

Interoperability endpoints

  • Direct secure messaging: lconley384017@hisp.ehr.sutterhealth.org

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 4

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1790281053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10058 WOLF RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959498194",
            "telephone_number": "530-745-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 N Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937012302",
            "country_code": "US",
            "telephone_number": "559-499-6450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYON",
        "first_name": "LEANDRA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "17756",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A17756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANDRA",
            "last_name": "CONLEY",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.