1. Home
  2. Directory
  3. California
  4. Pleasanton
  5. Psychiatry Neurology
  6. NPI Profile

LYNNE R. MIELKE M.D.
NPI 1700985413
Psychiatry & Neurology - Neurodevelopmental Disabilities in Pleasanton, CA

Active since September 21, 2006Opted out of Medicare · through Oct 1, 2026CLIA 05D2002532 · Waiver
4463 STONERIDGE DR STE A, PLEASANTON, CA 94588(925) 846-6300(925) 846-6323 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lynne R. Mielke M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LYNNE R. MIELKE M.D. (NPI 1700985413) is an individual neurodevelopmental disabilities provider in Pleasanton, California, licensed in California (G59017) and active in the NPI registry since September 2006. She has opted out of Medicare through October 1, 2026 and remains eligible to order and refer and holds a CLIA Waiver certificate valid through January 19, 2028.

NPPES Registry Identity

NPI1700985413
Entity TypeIndividualFemale
Primary Taxonomy2084P0005X
Provider Legal NameLYNNE R. MIELKECredential: M.D.
Location Address4463 STONERIDGE DR STE APleasanton, CA 94588-8402
Mailing Address4463 Stoneridge Dr Ste APleasanton, CA 94588-8402 · (925) 846-6300 · Fax (925) 846-6323
Phone(925) 846-6300
Fax(925) 846-6323
Sole ProprietorYes
Enumeration DateSeptember 21, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1700985413 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurodevelopmental DisabilitiesAllopathic & Osteopathic Physicians
Taxonomy Code2084P0005X
License✔ Licensed in CA · G59017
Definition
A neurologist who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions.
4463 STONERIDGE DR STE A, Pleasanton, CA 94588
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINF02058CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Lynne R. Mielke M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2014 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2014
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2002532

Lynne Mielke MD · Pleasanton, CA
Active · expires Jan 19, 2028
CLIA Number05D2002532
Laboratory TypePhysician Office
Certificate Effective DateJanuary 20, 2026
Certificate Expiration DateJanuary 19, 2028
Laboratory DirectorLynne Mielke
Laboratory Phone(925) 846-6300
Laboratory LocationLynne Mielke MD4463 Stoneridge Dr Ste A, Pleasanton, CA 94588
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SANDRA ANN KREIZENBECK NP
Nurse Practitioner (Family)
4463 STONERIDGE DR STE A
PLEASANTON, CA 94588
Alameda County (925) 846-6300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lynne Mielke's NPI number?

The NPI number for Lynne Mielke is 1700985413. It was assigned to this individual provider in the NPPES registry on September 21, 2006.

Where is Lynne Mielke located?

Lynne Mielke practices at 4463 Stoneridge Dr Ste A, Pleasanton, CA 94588. The listed phone number is (925) 846-6300.

What is Lynne Mielke's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurodevelopmental Disabilities, with taxonomy code 2084P0005X.

Is Lynne Mielke enrolled in Medicare?

No. Lynne Mielke has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Does Lynne Mielke hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2002532) is associated with this NPI, valid through January 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lynne Mielke was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.