Lori Ann Doyle, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA13554 Issued in CA

Practice address

401 Paradise Rd
Modesto, CA 95351-3163

Phone

(209) 558-4000

NPI assigned

Jan 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lori Ann Long Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1982755161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 PARADISE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953513163",
            "telephone_number": "209-558-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PARADISE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953513163",
            "telephone_number": "209-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2023-03-07",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA13554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC.",
            "identifier": "PA13554",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "LONG",
            "middle_name": "ANN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Modesto, CA
• Providers in Modesto, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.