NPIMap

Individual provider Active NPI

Lily N Enayati, MD

  • Internal Medicine Physician
  • San Mateo, CA
National Provider Identifier
1447322847
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G078301 Issued in CA
Practice address
1 Baywood Ave Ste 10
San Mateo, CA 94402-1537
Phone
(650) 342-2974
Fax
(650) 347-5404
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G078301 CA Primary

Addresses

Primary practice location

1 Baywood Ave Ste 10
San Mateo, CA 94402-1537

Mailing address

1 Baywood Ave Ste 10
San Mateo, CA 94402-1537
Phone (650) 342-2974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050503001377 CA Practitioner - Internal Medicine 8729028386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Baywood Ave
Suite 10
San Mateo, CA 94402-1537
Phone (650) 342-2974

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G078301CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince May 6, 2021 Accepting new patients
Lily Enayati MD Inc Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Permanente Medical Group Inc Internal Medicine Current Accepting new patients
Permanente Medical Group Inc Internal Medicine CurrentSince May 6, 2021 Accepting new patients
Mills-Peninsula Health Services Past Accepting new patients
Francis H Koch MD Inc Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

1 Baywood Ave
Ste 10
San Mateo, CA 94402
Phone (650) 342-2974

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

1200 El Camino Real
South San Francisco, CA 94080
Phone (650) 742-2100

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Interoperability endpoints

  • Direct secure messaging: lenayati26882@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 12

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1447322847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYWOOD AVE STE 10",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021537",
            "telephone_number": "650-342-2974",
            "fax_number": "650-347-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAYWOOD AVE STE 10",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021537",
            "telephone_number": "650-342-2974",
            "fax_number": "650-347-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENAYATI",
        "first_name": "LILY",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G078301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.