Individual provider Active NPI

Lily Tumbaga-Notario, M.D.

  • Internal Medicine Physician
  • Lodi, CA
National Provider Identifier
1710910336
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A64410 Issued in CA
Practice address
999 S Fairmont Ave
Lodi, CA 95240-5100
Phone
(209) 366-2001
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 A64410 CA Primary

Addresses

Primary practice location

999 S Fairmont Ave
Lodi, CA 95240-5100

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097

Other practice location 1

918 S Fairmont Ave
Lodi, CA 95240-5119
Phone (209) 366-2001

Other practice location 2

918 S Fairmont Ave
Lodi, CA 95240-5119
Phone (209) 366-2001

Other names 1

  • Lily Notario 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
I20040415000910 CA Practitioner - Internal Medicine 3678568144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Saint Louis University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1300 W Lodi Ave
Suite P
Lodi, CA 95242-3038
Phone (209) 366-1990

2800 L St
Sacramento, CA 95816-5616

815 Court St
Jackson, CA 95642-2154

999 S Fairmont Ave
Suite 130 and 200
Lodi, CA 95240-5100
Phone (209) 366-2001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Mar 1, 2016 Accepting new patients
Sutter Valley Medical Foundation Internal Medicine Current Accepting new patients
Sutter Valley Medical Foundation Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
Lodi Memorial Hospital Association Inc Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

999 S Fairmont Ave
Ste 130
Lodi, CA 95240
Phone (209) 334-3377

918 S Fairmont Ave
Lodi, CA 95240
Phone (209) 336-2000

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

460 Plumas Blvd
Ste 202
Yuba City, CA 95991
Phone (530) 749-5500

Interoperability endpoints

  • Direct secure messaging: ltumbaganotario41197@hisp.ehr.sutterhealth.org

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 8

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1710910336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405100",
            "telephone_number": "209-366-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "918 S Fairmont Ave",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952405119",
            "country_code": "US",
            "telephone_number": "209-366-2001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "918 S Fairmont Ave",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952405119",
            "country_code": "US",
            "telephone_number": "209-366-2001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUMBAGA-NOTARIO",
        "first_name": "LILY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A64410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILY",
            "last_name": "NOTARIO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.