Individual provider Active NPI

Katherine Margaret Federle, D.C.

  • Chiropractor
  • Menlo Park, CA
National Provider Identifier
1013010396
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC15196 Issued in CA
Practice address
630 Oak Grove Avenue
Menlo Park, CA 94025-4318
Phone
(650) 323-6294
Fax
(650) 324-9898
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC15196 CA Primary

Addresses

Primary practice location

630 Oak Grove Avenue
Menlo Park, CA 94025-4318

Mailing address

630 Oak Grove Avenue
Menlo Park, CA 94025-4318
Phone (650) 323-6294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081118000319 CA Practitioner - Chiropractic 1759441934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

950 Woodside Rd
Suite 1
Redwood City, CA 94061-3643
Phone (650) 599-9470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC15196CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Katherine M Federle DC Acpc CurrentSince Jan 8, 1983 Accepting new patients

Locations

630 Oak Grove Ave
Menlo Park, CA 94025
Phone (650) 323-6294

950 Woodside Rd
Ste 1
Redwood City, CA 94061
Phone (650) 599-9470

Organizations & group practices 1

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013010396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 OAK GROVE AVENUE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254318",
            "telephone_number": "650-323-6294",
            "fax_number": "650-324-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 OAK GROVE AVENUE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254318",
            "telephone_number": "650-323-6294",
            "fax_number": "650-324-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDERLE",
        "first_name": "KATHERINE",
        "middle_name": "MARGARET",
        "name_prefix": "Ms.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC15196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.