Individual provider Active NPI

Gena Lee Lewis, MD

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1124053830
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A061397 Issued in CA
Practice address
5220 Claremont Ave
Oakland, CA 94618-1033
Phone
(510) 428-3885
Fax
(510) 547-2702
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A061397 CA Primary

Addresses

Primary practice location

5220 Claremont Ave
Oakland, CA 94618-1033

Mailing address

5220 Claremont Ave
Oakland, CA 94618-1033
Phone (510) 428-3885

Other identifiers 3

IdentifierTypeStateIssuer
GR0095800MedicaidCA
680572143OtherCAFEDERAL TAX ID NO. INPATI
542125582OtherCAFEDERAL TAX ID NO.-OUTPAT

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210629003796 CA Practitioner - Pediatric Medicine 9234530130 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A061397CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jun 24, 2021 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
University of California San Francisco CurrentSince Jun 24, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 24, 2021 Accepting new patients
University of California San Francisco Pediatrics CurrentSince Jun 24, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 24, 2021 Accepting new patients

Locations

5220 Claremont Ave
Oakland, CA 94618
Phone (510) 428-3129

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

Interoperability endpoints

  • Direct secure messaging: glewis120142@direct-ucsfmedicalcenter.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1124053830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 CLAREMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181033",
            "telephone_number": "510-428-3885",
            "fax_number": "510-547-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 CLAREMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181033",
            "telephone_number": "510-428-3885",
            "fax_number": "510-547-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "GENA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A061397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0095800",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID NO. INPATI",
            "identifier": "680572143",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID NO.-OUTPAT",
            "identifier": "542125582",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.