Individual provider Active NPI

Thomas M. Lietman, M.D.

  • Ophthalmology Physician
  • San Francisco, CA
National Provider Identifier
1932219292
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G80168 Issued in CA
Practice address
95 Kirkham St
San Francisco, CA 94143-0001
Phone
(415) 502-2662
Fax
(415) 476-0527
NPI assigned
Aug 30, 2006
Last updated
Jun 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G80168 CA Primary

Addresses

Primary practice location

95 Kirkham St
San Francisco, CA 94143-0001

Mailing address

1635 Divisadero St
Suite 625, Box 1821
San Francisco, CA 94143-0001

Other identifiers 1

IdentifierTypeStateIssuer
00G801680MedicaidCA

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
I20080306000551 CA Practitioner - Ophthalmology 9133204746 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G80168CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group CurrentSince Sep 16, 1975 Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2007 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2007 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
UCSF Medical Group Business Services Ophthalmology CurrentSince Jul 1, 2007 Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2007 Accepting new patients
Regents of the University of California CurrentSince Jul 23, 1997 Accepting new patients
University of California SFGH Medical Group Ophthalmology CurrentSince Sep 16, 1975 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

1001 Potrero Ave
Rm 3A
San Francisco, CA 94110
Phone (415) 206-4632

1001 Potrero Ave
Ste 1E21
San Francisco, CA 94110
Phone (415) 206-8111

1635 Divisadero St
Ste 625
San Francisco, CA 94115
Phone (415) 476-1977

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

533 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-7192

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1932219292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST",
            "address_2": "SUITE 625, BOX 1821",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 KIRKHAM ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001",
            "telephone_number": "415-502-2662",
            "fax_number": "415-476-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIETMAN",
        "first_name": "THOMAS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G80168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G801680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.