Individual provider Active NPI

Mary Jia Ling Lim, D.O.

  • Ophthalmology Physician
  • San Ramon, CA
National Provider Identifier
1609212208
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
20A14080 Issued in CA
Practice address
2301 Camino Ramon Ste 104
San Ramon, CA 94583-2029
Phone
(925) 277-1135
NPI assigned
May 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 5101023729 MI
Ophthalmology Physician 207W00000X 20A14080 CA Primary

Addresses

Primary practice location

2301 Camino Ramon Ste 104
San Ramon, CA 94583-2029

Mailing address

2301 Camino Ramon Ste 104
San Ramon, CA 94583-2029
Phone (925) 277-1135

Other names 1

  • Mary J Lim Former name

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
I20241125004323 CA Practitioner - OphthalmologyPractitioner - Other (Physician) 5597011056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.49 of 100Reported as group
Quality
78.04
Promoting interoperability
100
Improvement activities
40
Cost
75.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14080CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Health Medical Foundation CurrentSince Aug 25, 2024 Accepting new patients

Locations

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

2301 Camino Ramon
Ste 104
San Ramon, CA 94583
Phone (925) 277-1135

Interoperability endpoints

  • Direct secure messaging: mlim332640@direct-ucsfmedicalcenter.org

Organizations & group practices 1

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": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1609212208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 CAMINO RAMON STE 104",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945832029",
            "telephone_number": "925-277-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 CAMINO RAMON STE 104",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945832029",
            "telephone_number": "925-277-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "MARY",
        "middle_name": "JIA LING",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "5101023729",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "20A14080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LIM",
            "middle_name": "J",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.