Lily Medrano, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

304182 Issued in CA

Practice address

4094 4TH Ave
San Diego, CA 92103-2143

Phone

(619) 515-2545

NPI assigned

Jul 7, 2023

Last updated

Jul 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Health Centers of San Diego, Inc

  dba Logan Heights Family Health Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment NPD
• Family Health Centers of San Diego, Inc

  dba Escondido Physical Health and Wellness

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• Family Health Centers of San Diego, Inc.

  dba Family Health Center of San Diego - Hospital

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
  • NPI 1326231713
  NPD

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1710665989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 73RD ST APT 16",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921151894",
            "telephone_number": "209-484-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4094 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032143",
            "telephone_number": "619-515-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "LILY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jena Medrano
• Joseph Medrano
• Karlo Lagrisola Medrano
• Kyle Rene Medrano
• Lidia Balderas Medrano
• Shantal Medrano
• Medsd, Inc.
• Medwatchers
• Medzed Physician Services, Inc.
• Medzed Physician Services, Inc.

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.