Lisa Marie King, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95006001 Issued in CA

Practice address

3100 Summit St FL 2
Oakland, CA 94609-3412

Phone

(510) 869-8865

Fax

(510) 869-6271

NPI assigned

Apr 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1003267196
  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Alta Bates Summit Medical Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1043358542
  NPD (past)
• Sutter Bay Hospitals

  • Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1194171371
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1295181477
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004
  Care Compare affiliation

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1881129369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-869-8865",
            "fax_number": "510-569-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SUMMIT ST FL 2",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093412",
            "telephone_number": "510-869-8865",
            "fax_number": "510-869-6271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Hawthorne Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946093108",
            "country_code": "US",
            "telephone_number": "510-869-6883",
            "fax_number": "510-869-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1441 N Tracy Blvd",
            "address_purpose": "LOCATION",
            "city": "Tracy",
            "state": "CA",
            "postal_code": "953763445",
            "country_code": "US",
            "telephone_number": "209-835-8910",
            "fax_number": "209-835-7438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006001",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95006001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "95006001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet A King, MFC
• Jessie James King Jr.
• John Richard King, P.T.
• Kausha King
• Kelvin King
• Marilee James King, MFT
• Melinda King
• Michael Durward King
• Monroe Damien King
• Patricia Anne King, M.A., B.S.W., A.A.

• Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.