Fredilyn M Lipata, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

2010-01116 Issued in NC

Practice address

101 Bodin Cir
60 MDG/Pathology
Travis Afb, CA 94535-1800

Phone

(707) 816-5676

NPI assigned

Jan 27, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1201392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1750568234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-816-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "60 MDG/PATHOLOGY",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351800",
            "telephone_number": "707-816-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPATA",
        "first_name": "FREDILYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-27",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "2010-01116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Nicole Lieberman, DPT
• Benjamin Jacob Lifto, IDMT
• Elenia Lin
• Jeremy Linden
• Subrina V Linscomb, PT
• Douglas M. Littlefield, DDS
• Regina Simone Livingston, PA-C
• Alexander Lo, MD
• Robert S Locke, M.D.
• Cheryl C Lockhart, SRNA

• Anatomic Pathology & Clinical Pathology Physician in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.