Individual provider Active NPI

Lilly I Kao, M.D.

  • Psychiatry Physician
  • Long Beach, CA
National Provider Identifier
1508830589
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C53602 Issued in CA
Practice address
5199 E Pacific Coast Hwy Ste 330N
Long Beach, CA 90804-3353
Phone
(562) 365-2020
NPI assigned
Feb 15, 2006
Last updated
Feb 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35-081057 OH
Psychiatry Physician 2084P0800X C53602 CA Primary

Addresses

Primary practice location

5199 E Pacific Coast Hwy Ste 330N
Long Beach, CA 90804-3353

Mailing address

5199 E Pacific Coast Hwy Ste 330N
Long Beach, CA 90804-3353
Phone (562) 365-2020

Other identifiers 1

IdentifierTypeStateIssuer
2411983MedicaidOH

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
I20101011000611 CA Practitioner - Psychiatry 3971795857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Northeastern Ohio University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4000 Macarthur Blvd
Suite 600 East Tower
Newport Beach, CA 92660-2517

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53602CAMDPharmacist
C53602CAMDPsychiatry Physician
35-081057OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast, Inc CurrentSince Aug 1, 2017 Accepting new patients
Marcus Zachary, D.O., P.C. CurrentSince Feb 1, 2022 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Aug 1, 2017 Accepting new patients

Locations

7111 N Fresno St
Ste 200
Fresno, CA 93720
Phone (415) 353-6817

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

Interoperability endpoints

  • Direct secure messaging: lilly.kao.1@17363.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1508830589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5199 E PACIFIC COAST HWY STE 330N",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043353",
            "telephone_number": "562-365-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5199 E PACIFIC COAST HWY STE 330N",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043353",
            "telephone_number": "562-365-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAO",
        "first_name": "LILLY",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-081057",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C53602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2411983",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.