NPIMap

Organization Active NPI

San Mateo Dialysis Associates

  • Nephrology Physician
  • Burlingame, CA
National Provider Identifier
1275604183
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G44819 Issued in CA
Legal business name
SAN MATEO DIALYSIS ASSOCIATES
Practice address
1750 El Camino Real
15
Burlingame, CA 94010-3208
Phone
(650) 692-6302
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Authorized official

Name
Dr. Fred Yee Hang Lui, MDNPI 1265461644
Title
Owner
Phone
(650) 692-6302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X G44819 CA Primary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X G60085 CA

Addresses

Primary practice location

1750 El Camino Real
15
Burlingame, CA 94010-3208

Mailing address

PO Box 730
San Mateo, CA 94401-4022
Phone (650) 341-0725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412001216 CA Part B Supplier - Clinic/Group Practice 5193719268 Receives reassigned benefits from 14 practitioners
Practice locations: Burlingame, CA; Daly City, CA; Redwood City, CA; San Mateo, CA; South San Francisco, CA

National Provider Directory

National Provider Directory

Locations

1410 Marshall St
Redwood City, CA 94063
Phone (650) 366-0789

36 S El Camino Real
Ste 103
San Mateo, CA 94401

91 Westborough Blvd
Ste 1020
South San Francisco, CA 94080
Phone (650) 741-4180

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1275604183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944014022",
            "telephone_number": "650-341-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 EL CAMINO REAL",
            "address_2": "15",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103208",
            "telephone_number": "650-692-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MATEO DIALYSIS ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "LUI",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "YEE HANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-692-6302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G44819",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G60085",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.