Individual provider Active NPI

Ivy Rose Loreto Lorilla, MD

  • Family Medicine Physician
  • San Carlos, CA
National Provider Identifier
1912163619
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A127118 Issued in CA
Practice address
301 Industrial Rd
San Carlos, CA 94070-2603
Phone
(650) 596-4000
NPI assigned
Aug 1, 2008
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 48501 CT
Family Medicine Physician 207Q00000X A127118 CA Primary

Addresses

Primary practice location

301 Industrial Rd
San Carlos, CA 94070-2603

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (650) 551-7043

Other practice location 1

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (203) 854-9292

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
I20140110000944 CA Practitioner - Family Practice 6406035559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 2007
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)

301 Industrial Rd
San Carlos, CA 94070-2603
Phone (415) 600-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A127118CAMDFamily Medicine Physician
48501CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Family Medicine CurrentSince Sep 10, 2018 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Dec 1, 2013 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 10, 2018 Accepting new patients
Stamford Hospital Past Accepting new patients

Locations

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

27212 Calaroga Ave
Hayward, CA 94545
Phone (510) 783-5532

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

3100 Telegraph Ave
Ste 2102
Oakland, CA 94609
Phone (510) 286-8160

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

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

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

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 780-0110

301 Industrial Rd
San Carlos, CA 94070
Phone (650) 596-4000

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2128 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 425-0727

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: ilorilla228959@hisp.ehr.sutterhealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1912163619",
    "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": "650-551-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 INDUSTRIAL RD",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702603",
            "telephone_number": "650-596-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Welch Rd",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041601",
            "country_code": "US",
            "telephone_number": "203-854-9292",
            "fax_number": "203-854-9437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LORILLA",
        "first_name": "IVY ROSE",
        "middle_name": "LORETO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "48501",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A127118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

Verify at the official NPI Registry.