Individual provider Active NPI

Lydia Ann Tinajero-Deck, M.D.

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1447287222
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G78528 Issued in CA
Practice address
5220 Claremont Ave
Oakland, CA 94618-1033
Phone
(510) 428-3129
Fax
(510) 547-2702
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 G78528 CA Primary

Addresses

Primary practice location

5220 Claremont Ave
Oakland, CA 94618-1033

Mailing address

747 52ND St
Oakland, CA 94609-1809
Phone (510) 428-3129

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
I20210702001275 CA Practitioner - Pediatric Medicine 8729489380 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G78528CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Pediatrics CurrentSince Jun 23, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 23, 2021 Accepting new patients
University of California San Francisco CurrentSince Jun 23, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 23, 2021 Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jun 23, 2021 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients
University of California San Francisco Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
Children'S Hospital & Research Center at Oakland Past Accepting new patients

Locations

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

5220 Claremont Ave
Oakland, CA 94618
Phone (510) 428-3129

5400 Telegraph Ave
Oakland, CA 94609
Phone (510) 428-3226

5275 Claremont Ave
Oakland, CA 94618
Phone (510) 428-3050

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

2401 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 979-4000

Interoperability endpoints

  • Direct secure messaging: ltinajerodeck119006@direct-ucsfmedicalcenter.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447287222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3129",
            "fax_number": "510-547-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 CLAREMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181033",
            "telephone_number": "510-428-3129",
            "fax_number": "510-547-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINAJERO-DECK",
        "first_name": "LYDIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G78528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.