Jackson M Lim, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E4263 Issued in CA

Practice address

1531 Plumas CT
Suite a
Yuba City, CA 95991-2960

Phone

(530) 674-9737

Fax

(530) 674-9734

NPI assigned

Nov 9, 2005

Last updated

Oct 29, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peach Tree HealthcareGroup PAC ID 7416978440, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health and Rideout Hospital, Marysville, CA, CCN 050133

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jackson.lim.p1@direct.peachtreehealth.nextgenshare.com

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.

• Peach Tree Healthcare

  dba Peach Tree Clinic

  • Federally Qualified Health Center (FQHC)
  • Marysville, CA
  • NPI 1003863622

  Podiatrist

  Medicare reassignment Care Compare group NPD
• Peach Tree Healthcare

  dba Peach Tree North Sacramento II

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1245043413
  NPD
• Rideout Memorial Hospital

  dba Adventist Health and Rideout

  • General Acute Care Hospital
  • Marysville, CA
  • NPI 1720088354
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rideout Memorial Hospital

  dba Adventist Health and Rideout

  • General Acute Care Hospital
  • Marysville, CA
  • NPI 1720088354
  Care Compare affiliation

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1073594727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 PLUMAS CT",
            "address_2": "SUITE A",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959912960",
            "telephone_number": "530-674-9737",
            "fax_number": "530-674-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 PLUMAS CT",
            "address_2": "SUITE A",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959912960",
            "telephone_number": "530-674-9737",
            "fax_number": "530-674-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "JACKSON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4263",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E4263",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E42630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremiah Clinton Lewis, PA-C
• Kevin Li, MD
• Ying Li
• Jack Liang
• Lifereach Transportation
• Jeff Limary, LCSW
• Lincare Inc.
• Richard Charles Lind, M.A., CCC-A
• Erica Linehan, AMFT
• Vijay Gandhi Linga, M.D.

• Podiatrist in Yuba City, CA
• Providers in Yuba City, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; 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.