Individual provider Active NPI

Lily Emiko Friedman

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1255794442
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A153441 Issued in CA
Practice address
747 52ND St
UCSF Benioff Children'S Hospital Oakland
Oakland, CA 94609-1809
Phone
(510) 428-3331
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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 A153441 CA Primary

Addresses

Primary practice location

747 52ND St
UCSF Benioff Children'S Hospital Oakland
Oakland, CA 94609-1809

Mailing address

637 59TH St
Oakland, CA 94609-1415

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
I20200826001457 CA Practitioner - Pediatric Medicine 9436576121 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A153441CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc CurrentSince Sep 1, 2020 Accepting new patients
La Clinica de la Raza, Inc. CurrentSince Sep 1, 2020 Accepting new patients
La Clinica de la Raza Inc Current Accepting new patients
Children'S Hospital & Research Center at Oakland Past Accepting new patients

Locations

1030 International Blvd
Oakland, CA 94606
Phone (510) 238-5400

2021 Main St
Oakley, CA 94561
Phone (925) 776-8200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lfriedman403454@hisp.ehr.sutterhealth.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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1255794442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 59TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "address_2": "UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "LILY",
        "middle_name": "EMIKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A153441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.