LULU M. GIZAW (PA-C) – Medical Physician Assistant, NPI 1962417345

LULU M. GIZAW (PA-C) is a healthcare provider. based in Emeryville, California. specializing in Medical Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA10004354 (WA). The NPI Number for LULU M. GIZAW (PA-C) is 1962417345

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
LULU M. GIZAW (PA-C)
NPI
1962417345
Phone
(510) 851-7423
Address
2100 POWELL ST
Enumeration Date
31 July 2006
Last Update Date
25 July 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4252612000
Graduation Year
2002 (24 years ago)
PAC ID
2466347695
Group Practice PAC ID
8325100480
Professional Enrollment ID
I20040217000956
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for LULU M. GIZAW (PA-C)

  • 2100 Powell Street, Bay Trail, Emeryville, Alameda County, California, 94608, United States

    STE 900

    EMERYVILLE, CA 946081844

    Phone: (510) 851-7423

    Fax: (510) 879-9120

    Type: Mailing

  • Harborview Medical Center, 325, 9th Avenue, Little Saigon, First Hill, Seattle, King County, Washington, 98104, United States

    SEATTLE, WA 981042499

    Phone: (206) 744-3000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-02-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040217000956IPhysician AssistantWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making2424$0
99284Emergency department visit with moderate level of medical decision making1919$0
View full utilization report →

Insurance plans in this area (ZIP 94608)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325100480View full group profile

Reviews

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Frequently asked questions

Is LULU M. GIZAW (PA-C) listed with a National Provider Identifier?
Yes — LULU M. GIZAW (PA-C) has NPI 1962417345 on file in the registry.
Would LULU M. GIZAW (PA-C) appear as active to a payer?
You can treat LULU M. GIZAW (PA-C) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to LULU M. GIZAW (PA-C)?
LULU M. GIZAW (PA-C)'s specialty line reads Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is LULU M. GIZAW (PA-C) located near Emeryville?
LULU M. GIZAW (PA-C) currently maps to Emeryville, California in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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