Active NPI
Lyle John Rausch, PHD MD
- Dermatology Physician
- Redwood City, CA
National Provider Identifier
1730291261
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Apr 20, 2015.
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G45490
- Practice address
- 3060 Broadway St
Redwood City, CA 94062 - Phone
- (650) 361-1177
- Fax
- (650) 361-1826
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G45490 | CA | Primary |
Addresses
Primary practice location
3060 Broadway St
Redwood City, CA 94062
Mailing address
1039 Twin Oak CT
Redwood City, CA 94061
Phone (650) 361-1329
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G45490 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730291261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1039 TWIN OAK CT",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "94061",
"telephone_number": "650-361-1329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3060 BROADWAY ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "94062",
"telephone_number": "650-361-1177",
"fax_number": "650-361-1826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAUSCH",
"first_name": "LYLE",
"middle_name": "JOHN",
"credential": "PHD MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G45490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.