NPIMap

Individual provider Active NPI

Elizabeth A. Kidd, M.D.

  • Radiation Oncology Physician
  • Stanford, CA
National Provider Identifier
1760508899
Registry record updated Feb 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A112524 Issued in CA
Practice address
875 Blake Wilbur Dr.
Stanford Cancer Center, Mail Code 5847
Stanford, CA 94305-5847
Phone
(650) 723-6171
Fax
(650) 725-8231
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Therapeutic Radiology Physician 2085R0203X A112524 CA
Radiation Oncology Physician 2085R0001X A112524 CA Primary

Addresses

Primary practice location

875 Blake Wilbur Dr.
Stanford Cancer Center, Mail Code 5847
Stanford, CA 94305-5847

Mailing address

875 Blake Wilbur Dr.
Stanford Cancer Center, Mail Code 5847
Stanford, CA 94305-5847
Phone (650) 723-6171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826001023 CA Practitioner - Radiation Oncology 5991829053 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Washington University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112524CAMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile CurrentSince Jul 1, 2020 Accepting new patients
Stanford Health Care CurrentSince Aug 1, 2010 Accepting new patients
University Healthcare Alliance CurrentSince Jul 1, 2020 Accepting new patients
Stanford Health Care CurrentSince Aug 1, 2010 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Affinity Medical Group Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

875 Blake Wilbur Dr
Palo Alto, CA 94304
Phone (650) 723-7621

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

5725 W Las Positas Blvd
Ste 100
Pleasanton, CA 94588

5725 W Las Positas Blvd
Ste 100B
Pleasanton, CA 94588
Phone (925) 621-7700

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: ekidd50719@direct.stanfordhealthcare.org

Organizations & group practices 7

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 7

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392422400000",
    "number": "1760508899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 BLAKE WILBUR DR.",
            "address_2": "STANFORD CANCER CENTER, MAIL CODE 5847",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055847",
            "telephone_number": "650-723-6171",
            "fax_number": "650-725-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 BLAKE WILBUR DR.",
            "address_2": "STANFORD CANCER CENTER, MAIL CODE 5847",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055847",
            "telephone_number": "650-723-6171",
            "fax_number": "650-725-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2014-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "CA",
            "license": "A112524",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A112524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.