Individual provider Active NPI

Hillis Lynn Warren, M.D.

  • Specialist
  • Sacramento, CA
National Provider Identifier
1801999602
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G030438 Issued in CA
Practice address
2620 Hurley Way
Ste a
Sacramento, CA 95864-3789
Phone
(916) 929-1838
Fax
(916) 929-1753
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G030438 CA Primary

Addresses

Primary practice location

2620 Hurley Way
Ste a
Sacramento, CA 95864-3789

Mailing address

2620 Hurley Way
Ste a
Sacramento, CA 95864-3789
Phone (916) 453-1111

Other identifiers 1

IdentifierTypeStateIssuer
00G304380MedicaidCA

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
I20101103000412 CA Practitioner - Ophthalmology 2163616186 Reassigns benefits to 1 organization
Practice locations: Sacramento, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G030438CAMDSpecialist

Interoperability endpoints

  • Direct secure messaging: hillis.warren.p1@direct.retinalmd.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1801999602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 HURLEY WAY",
            "address_2": "STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958643789",
            "telephone_number": "916-453-1111",
            "fax_number": "916-483-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 HURLEY WAY",
            "address_2": "STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958643789",
            "telephone_number": "916-929-1838",
            "fax_number": "916-929-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "HILLIS",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G030438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G304380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.