NPIMap

Individual provider Active NPI

Lloyd Tomoaki Miyawaki, MD

  • Radiation Oncology Physician
  • Greenbrae, CA
National Provider Identifier
1497737464
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
G81328 Issued in CA
Practice address
1350 S Eliseo Dr
Ste 100
Greenbrae, CA 94904-2011
Phone
(209) 342-2300
Fax
(209) 524-4240
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X G81328 CA Primary

Addresses

Primary practice location

1350 S Eliseo Dr
Ste 100
Greenbrae, CA 94904-2011

Mailing address

4301 Northstar Way
Modesto, CA 95356-9262
Phone (209) 342-2300

Other identifiers 2

IdentifierTypeStateIssuer
00G813280MedicaidCA
00G813280OtherCABLUE SHIELD

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
I20081125000097 CA Practitioner - Radiation Oncology 8527128339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of California, San Francisco School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marin Cancer Care, Inc.Group PAC ID 1557542289, 13 clinicians

Practice addresses (Care Compare)

1350 S Eliseo Dr
Suite 200
Greenbrae, CA 94904-2018
Phone (415) 925-5000

Hospital & facility affiliations

  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360
  • Novato Community Hospital Hospital, Novato, CA, CCN 050131
  • Sonoma Valley Hospital Hospital, Sonoma, CA, CCN 050090
  • UCSF Medical Center Hospital, San Francisco, CA, CCN 050454

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81328CAMDPharmacist
G81328CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marin Cancer Care Inc Radiation Oncology CurrentSince Dec 4, 2010 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Marin Radiation Oncology Medical Group Radiation Oncology Past Accepting new patients
Marin General Hospital Past Accepting new patients
California Cancer Care, Inc. Past Accepting new patients

Locations

1350 S Eliseo Dr
Ste 100
Greenbrae, CA 94904
Phone (415) 492-4800

1350 S Eliseo Dr
Ste 200
Greenbrae, CA 94904
Phone (415) 925-5000

651 1st St W
Ste L
Sonoma, CA 95476
Phone (707) 935-5189

Organizations & group practices 5

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 4

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1497737464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NORTHSTAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S ELISEO DR",
            "address_2": "STE 100",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042011",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYAWAKI",
        "first_name": "LLOYD",
        "middle_name": "TOMOAKI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G81328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G813280",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G813280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.