Elaine Rotha Lim

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA56935 Issued in CA

Practice address

355 Lennon LN Ste 255
Walnut Creek, CA 94598

Phone

(925) 932-7704

Fax

(925) 932-7752

NPI assigned

Apr 22, 2019

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

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

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden State Dermatology Associates, Inc.Group PAC ID 1052418175, 118 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Golden State Dermatology Associates, Inc.

  • Dermatology Physician
  • Walnut Creek, CA
  • NPI 1700860871
  Medicare reassignment Care Compare group
• Golden State Dermatology Associates, Inc.

  • Ambulatory Surgical Clinic/Center
  • Fresno, CA
  • NPI 1235738576
  NPD
• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1982267290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 LENNON LN STE 255",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982496",
            "telephone_number": "925-932-7704",
            "fax_number": "925-932-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 LENNON LN STE 255",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-932-7704",
            "fax_number": "925-932-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "ELAINE",
        "middle_name": "ROTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56935",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA56935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifeease Medical Supplies LLC
• Lightyear Health Clinic California, PC
• David Adrian Lilienstein, MD
• Andrea Lim, MD
• Christina Lim, PHARM.D.
• Jean Sy Lim, R.N.
• Mira Lim, M.D.
• Semi Lim, D.M.D
• Zachary Lim
• Rosemary Lima, MA

• Surgical Physician Assistant in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.