Individual provider Active NPI

Jennifer Lee Lyons, PA-C

  • Medical Physician Assistant
  • San Diego, CA
National Provider Identifier
1841495140
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA19106 Issued in CA
Practice address
8765 Aero Dr
Suite 130
San Diego, CA 92123-1781
Phone
(858) 541-0181
Fax
(858) 430-0919
NPI assigned
Jun 18, 2007
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA19106 CA Primary

Addresses

Primary practice location

8765 Aero Dr
Suite 130
San Diego, CA 92123-1781

Mailing address

8765 Aero Dr
Suite 130
San Diego, CA 92123-1781
Phone (858) 541-0181

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090124000107 CA Practitioner - Physician Assistant 2769546464 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Focus on Health IncGroup PAC ID 0648624254, 63 clinicians

Practice addresses (Care Compare)

San Diego, CA 92123
Phone (858) 541-0181

8765 Aero Dr
Suite 130
San Diego, CA 92123-1767
Phone (858) 541-0181

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
19106CAMDOccupational Therapist
PA19106CAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: jlyons24646@sharphealthcare.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1841495140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 AERO DR",
            "address_2": "SUITE 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231781",
            "telephone_number": "858-541-0181",
            "fax_number": "858-430-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 AERO DR",
            "address_2": "SUITE 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231781",
            "telephone_number": "858-541-0181",
            "fax_number": "858-430-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.