Lydia Canavan, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G58166 Issued in CA

Practice address

10150 Sorrento Valley Rd
Suite 320
San Diego, CA 92121-1635

Phone

(858) 454-4235

Fax

(858) 454-4644

NPI assigned

May 15, 2006

Last updated

Dec 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Diagnostic Radiology

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• California Imaging Institute Medical Group Inc

  • Radiology Clinic/Center
  • Fresno, CA
  • NPI 1497764468
  Medicare reassignment NPD
• Pronet Imaging Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1528099488
  Medicare reassignment NPD
• San Fernando Valley Interventional Radiology and Imaging Center

  • Vascular-Interventional Technology Radiologic Technologist
  • Encino, CA
  • NPI 1942350889
  Medicare reassignment NPD
• Central Valley Community Medical Imaging

  dba Cmi

  • Diagnostic Radiology Physician
  • Fresno, CA
  • NPI 1376637264
  Medicare reassignment
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Diagnostic Radiology

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Herndon Healthcare, Inc.

  dba Herndon Pharmacy

  • Pharmacy
  • Fresno, CA
  • NPI 1013917483
  NPD (past)
• Imaging Healthcare Specialists Medical Group, Inc.

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1750498093
  NPD (past)
• La Jolla Radiology Medical Group - Diagnosis, Inc.

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1689627317
  NPD (past)
• LJR Neuro Interventional Medical Group Inc

  • Diagnostic Radiology Physician
  • La Jolla, CA
  • NPI 1649441858
  NPD (past)
• Open Air MRI Centers Medical Group, Inc.

  • Vascular & Interventional Radiology Physician
  • San Diego, CA
  • NPI 1164475174

  Diagnostic Radiology

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1851342539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910229",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921910229",
            "telephone_number": "858-564-1400",
            "fax_number": "858-564-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 SORRENTO VALLEY RD",
            "address_2": "SUITE 320",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211635",
            "telephone_number": "858-454-4235",
            "fax_number": "858-454-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAVAN",
        "first_name": "LYDIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G58166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G581660",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7300 N Fresno St",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937202941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin Canale, MS, CPT
• Blancalaura Canales
• Jose Javier Canales, M.D.
• Viviana Christina Canas
• Allison Canavan, M.D.
• Raymond John Cancel
• Angela Candela
• Amber Lee Candelaria, OD
• Jaciel Candelaria
• Tanner Candelore, D.O.

• Diagnostic Radiology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.