Lily Tadayyon Kregenow, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00048510 Issued in WA

Practice address

316 Martin Luther King Jr Way
212
Tacoma, WA 98405-4252

Phone

(253) 383-5777

Fax

(253) 627-0855

NPI assigned

Mar 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Pediatric Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mendocino Coast Clinics, IncGroup PAC ID 5991619157, shared by 7 NPIs, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lkregenowmd7306@direct.multicare.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: lily.kregenow.p1@direct.mccinc.nextgenshare.com

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Diagnostic Radiology Physician
  • Spokane, WA
  • NPI 1679042188
  NPD
• Mendocino Coast Clinics Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Bragg, CA
  • NPI 1083783757
  NPD (past)

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1992766117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GARVEY PARKWAY",
            "city": "ST CHARLES",
            "state": "MD",
            "postal_code": "63303",
            "telephone_number": "636-441-7280",
            "fax_number": "636-939-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MARTIN LUTHER KING JR WAY",
            "address_2": "212",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054252",
            "telephone_number": "253-383-5777",
            "fax_number": "253-627-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREGENOW",
        "first_name": "LILY",
        "middle_name": "TADAYYON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00048510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas David Krause, M.D.
• Hatai Kraushaar, M.D.
• Chunneath Kravanh
• Heather Kravitz, RBT
• Don Lee Kreager, LICSW
• Robert D Kregenow, MD
• Julie L Kreger, DPT, ATC
• Creigh Kreinbrink
• Ronald Matthew Kreinbrink, MD
• Peter Kreishman, M.D.

• Pediatrics Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.