Individual provider Active NPI

Edward Mina Lim, MD

  • Psychiatry Physician
  • Bellevue, NE
National Provider Identifier
1386660447
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
28890 Issued in NE
Practice address
2231 Lincoln Rd
Bellevue, NE 68005-3907
Phone
(402) 291-1203
Fax
(402) 291-3915
NPI assigned
Jul 14, 2006
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A74054 CA
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 28890 NE Primary

Addresses

Primary practice location

2231 Lincoln Rd
Bellevue, NE 68005-3907

Mailing address

2201 Francisco Dr Ste 140-129
El Dorado Hills, CA 95762-3713
Phone (510) 755-5854

Other practice location 1

390 40th St
Oakland, CA 94609-2633
Phone (510) 379-4179

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
I20031211000649 CA Practitioner - Psychiatry 1850297664 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74054CAMDPharmacist
A74054CAMDPsychiatry Physician
28890NEMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Community Services, Inc. Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
Bay Area Community Services, Inc. Single Specialty Current Accepting new patients
Telecare Corporation CurrentSince Nov 15, 2015 Accepting new patients
Alameda Health System Single Specialty CurrentSince Jun 30, 2013 Accepting new patients
Telecare Corporation CurrentSince Nov 15, 2015 Accepting new patients
Telecare Corporation Single Specialty Current Accepting new patients
Alameda Health System Single Specialty CurrentSince Jun 30, 2013 Accepting new patients
Bay Area Community Services, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Traditions Psychiatry Group, P.C Single Specialty Past Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

15400 Foothill Blvd
Bldg E
Castro Valley, CA 94578
Phone (510) 895-4200

2201 Francisco Dr
Ste 140129
El Dorado Hills, CA 95762
Phone (510) 755-5854

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

280 17th St
Oakland, CA 94612
Phone (510) 238-5020

390 40th St
Oakland, CA 94609
Phone (510) 247-8235

559 16th St
Oakland, CA 94612
Phone (510) 318-6112

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1386660447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 FRANCISCO DR STE 140-129",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957623713",
            "telephone_number": "510-755-5854",
            "fax_number": "844-461-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 LINCOLN RD",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053907",
            "telephone_number": "402-291-1203",
            "fax_number": "402-291-3915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 40th St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946092633",
            "country_code": "US",
            "telephone_number": "510-379-4179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIM",
        "first_name": "EDWARD",
        "middle_name": "MINA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A74054",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "28890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

Verify at the official NPI Registry.