Individual provider Active NPI

Lee Roy Liskey, MD

  • Internal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1609990993
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A48467 Issued in CA
Practice address
2480 Mission St
Suite 108
San Francisco, CA 94110-2468
Phone
(415) 642-2000
Fax
(415) 642-0621
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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 A48467 CA Primary

Addresses

Primary practice location

2480 Mission St
Suite 108
San Francisco, CA 94110-2468

Mailing address

2480 Mission St
Suite 108
San Francisco, CA 94110-2468
Phone (415) 642-2000

Other identifiers 2

IdentifierTypeStateIssuer
943268785MedicaidCA
A48467OtherCAMEDICAL BOARD OF CALIFORNIA

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
I20040206000862 CA Practitioner - Internal Medicine 3577456052 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2480 Mission St
Suite 215
San Francisco, CA 94110-2480
Phone (415) 642-2000

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, San Francisco, CA, CCN 057003
  • California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
  • California Pacific Medical Center - Mission Bernal Hospital, San Francisco, CA, CCN 050055
  • California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047
  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48467CAMDInternal Medicine Physician

Hospital & facility affiliations 6

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1609990993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 MISSION ST",
            "address_2": "SUITE 108",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102468",
            "telephone_number": "415-642-2000",
            "fax_number": "415-642-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 MISSION ST",
            "address_2": "SUITE 108",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102468",
            "telephone_number": "415-642-2000",
            "fax_number": "415-642-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISKEY",
        "first_name": "LEE",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A48467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "943268785",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CALIFORNIA",
            "identifier": "A48467",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.