NPIMap

Individual provider Active NPI

Willie Dy Lu, MD

  • Specialist
  • Los Gatos, CA
National Provider Identifier
1114959558
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A495970 Issued in CA
Practice address
320 Dardanelli LN
Suite @ 21 B
Los Gatos, CA 95032-1440
Phone
(408) 866-8700
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A495970 CA Primary

Addresses

Primary practice location

320 Dardanelli LN
Suite @ 21 B
Los Gatos, CA 95032-1440

Mailing address

320 Dardanelli LN
Suite @ 21 B
Los Gatos, CA 95032-1440
Phone (408) 866-8700

Other identifiers 3

IdentifierTypeStateIssuer
00A495970OtherPTAN
1114959558OtherNPI
0046324MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100507000514 CA Practitioner - Internal Medicine 5193853349 Practice locations: Los Gatos, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

320 Dardanelli LN
Suite 21B
Los Gatos, CA 95032-1419
Phone (408) 866-8700

Hospital & facility affiliations

  • Prohealth Home Care, Inc Home health agency, San Jose, CA, CCN 058415
  • Centerwell Asian American Home Health Home health agency, Alameda, CA, CCN 557754
  • Good Samaritan Hospital Hospital, San Jose, CA, CCN 050380
  • El Camino Health Hospital, Mountain View, CA, CCN 050308
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A495970CAMDSpecialist

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1114959558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 DARDANELLI LN",
            "address_2": "SUITE @ 21 B",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321440",
            "telephone_number": "408-866-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 DARDANELLI LN",
            "address_2": "SUITE @ 21 B",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321440",
            "telephone_number": "408-866-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "WILLIE",
        "middle_name": "DY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A495970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "00A495970",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114959558",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0046324",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.