Individual provider Active NPI

Kenneth W. Lien, MD

  • Allergy Physician
  • Castro Valley, CA
National Provider Identifier
1396823092
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
A72098 Issued in CA
Practice address
20400 Lake Chabot Rd
Ste. 304
Castro Valley, CA 94546-5316
Phone
(510) 537-0700
Fax
(510) 537-7795
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X A72098 CA Primary

Addresses

Primary practice location

20400 Lake Chabot Rd
Ste. 304
Castro Valley, CA 94546-5316

Mailing address

20400 Lake Chabot Rd Ste 304
Ste. 304
Castro Valley, CA 94546-5316
Phone (510) 537-0700

Other identifiers 3

IdentifierTypeStateIssuer
CA110780OtherCAGRP PTAN FOR ALLERGY, ASTHMA & SINUS CENTERS OF SILICON VALLEY
1396823092MedicaidCA
EK627ZOtherCAINDIVIDUAL MEDICARE PTAN

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
I20070508000420 CA Practitioner - Allergy/Immunology 0840396818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Chicago, Pritzker School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20400 Lake Chabot Rd
Suite 304
Castro Valley, CA 94546-5316
Phone (510) 537-0700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72098CAMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Hospital District Past Accepting new patients
Upmc Washington Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1396823092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20400 LAKE CHABOT RD STE 304",
            "address_2": "STE. 304",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465316",
            "telephone_number": "510-537-0700",
            "fax_number": "510-537-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20400 LAKE CHABOT RD",
            "address_2": "STE. 304",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465316",
            "telephone_number": "510-537-0700",
            "fax_number": "510-537-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEN",
        "first_name": "KENNETH",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "A72098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP PTAN FOR ALLERGY, ASTHMA & SINUS CENTERS OF SILICON VALLEY",
            "identifier": "CA110780",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396823092",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE PTAN",
            "identifier": "EK627Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

Verify at the official NPI Registry.