Individual provider Active NPI

Kathleen Dolores Van Leeuwen, MD

  • Pediatric Surgery Physician
  • Sacramento, CA
National Provider Identifier
1003818642
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
C56170 Issued in CA
Practice address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(916) 734-3229
NPI assigned
Aug 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X C56170 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd
Sacramento, CA 95817-2201

Mailing address

3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1814

Other practice location 1

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0016

Other identifiers 1

IdentifierTypeStateIssuer
940610MedicaidAZ

Other names 1

  • Mrs. Kathleen Dolores Graziano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061026000475 AZ Practitioner - General SurgeryPractitioner - Other (Physician) 4385641745 Reassigns benefits to 2 organizations
I20260304001393 CA Practitioner - General SurgeryPractitioner - Pediatric Medicine 4385641745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Columbia University College of Physicians and Surgeons, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C56170CAMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Hospital Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jan 1, 2017 Accepting new patients
Regents of the Univ of Ca Surgery CurrentSince Mar 1, 2026 Accepting new patients
Regents of the Univ of Ca CurrentSince Mar 1, 2026 Accepting new patients
District Medical Group, Inc CurrentSince May 19, 2014 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jan 1, 2017 Accepting new patients
District Medical Group, Inc CurrentSince May 19, 2014 Accepting new patients
District Medical Group, Inc Surgery Past Accepting new patients

Locations

3370 S Mercy Rd
Ste 125
Gilbert, AZ 85297

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

1920 E Cambridge Ave
Ste 201
Phoenix, AZ 85006
Phone (602) 254-5561

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

Interoperability endpoints

  • Direct secure messaging: kvanleeuwen80549@direct.valleywisehealth.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1003818642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-3229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-933-0016",
            "fax_number": "602-933-4309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN LEEUWEN",
        "first_name": "KATHLEEN",
        "middle_name": "DOLORES",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "C56170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "940610",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "GRAZIANO",
            "middle_name": "DOLORES",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.