Individual provider Active NPI

Lisa M. Gil, MD

  • Family Medicine Physician
  • Riverbank, CA
National Provider Identifier
1447232988
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A74592 Issued in CA
Practice address
2603 Patterson Rd Ste 1
Riverbank, CA 95367-3407
Phone
(209) 869-5678
Fax
(209) 869-7657
NPI assigned
Nov 18, 2005
Last updated
Apr 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A74592 CA Primary

Addresses

Primary practice location

2603 Patterson Rd Ste 1
Riverbank, CA 95367-3407

Mailing address

1317 Oakdale Rd
Suite 440
Modesto, CA 95355-3361
Phone (209) 869-5678

Other identifiers 1

IdentifierTypeStateIssuer
00A745920OtherCABLUE SHIELD OF CA PIN

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
I20100223000442 CA Practitioner - Family Practice 9931243391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1317 Oakdale Rd
Suite 440
Modesto, CA 95355-3364
Phone (209) 522-3362

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A74592CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Medical Care a Professional Corporation Family Medicine CurrentSince Jan 27, 2015 Accepting new patients
Family First Medical Care a Professional Corporation CurrentSince Jan 27, 2015 Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
PHC-Las Cruces Inc Past Accepting new patients

Locations

1317 Oakdale Rd
Ste 410
Modesto, CA 95355
Phone (209) 522-3362

1317 Oakdale Rd
Ste 440
Modesto, CA 95355
Phone (209) 522-3362

2603 Patterson Rd
Ste 1
Riverbank, CA 95367
Phone (209) 521-2554

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1447232988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 OAKDALE RD",
            "address_2": "SUITE 440",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553361",
            "telephone_number": "209-869-5678",
            "fax_number": "209-869-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 PATTERSON RD STE 1",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953673407",
            "telephone_number": "209-869-5678",
            "fax_number": "209-869-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIL",
        "first_name": "LISA",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A74592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA PIN",
            "identifier": "00A745920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverbank, CA

Sources for this page

Verify at the official NPI Registry.