Tanya Lumbangaol

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA115 Issued in GU

Practice address

6768 Winter Night CT
Fontana, CA 92336-1417

Phone

(909) 782-2052

NPI assigned

Dec 5, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GU, CA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foothills Pain Management Clinic PCGroup PAC ID 5698828101, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Foothills Pain Management Clinic PC

  • Interventional Pain Medicine Physician
  • Covina, CA
  • NPI 1487885372
  Medicare reassignment Care Compare group
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment
• General Conference Corp of Sda

  dba Guam Seventh-Day Adventist Clinic

  • Clinic/Center
  • Tamuning, GU
  • NPI 1275586877
  Medicare reassignment
• Guam Dermatology Institute LLC

  dba Guam Dermatology Institute

  • Dermatology Physician
  • Tamuning, GU
  • NPI 1306404413
  Medicare reassignment
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Emanate Pain Management Medical Group PC

  • Interventional Pain Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1881458891

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1972018513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6768 WINTER NIGHT CT",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6768 WINTER NIGHT CT",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361417",
            "telephone_number": "909-782-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMBANGAOL",
        "first_name": "TANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "GU",
            "license": "PA115",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lizlyn Rose Lao Lucrida, NP
• Vanessa Luera
• Lauretta R Lugo
• Ronald J. Lugo, MD
• Kalisa Lum
• Vouch Kim Lun, D.P.M
• Frank T Luna
• Aileen P Luo
• Leon Luong, DO
• Sheetal Luthra, DO

• Physician Assistant in Fontana, CA
• Providers in Fontana, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.