Individual provider Active NPI

Katerina Maria Gallus, M.D.

  • Plastic Surgery Physician
  • San Diego, CA
National Provider Identifier
1104837129
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A67126 Issued in CA
Practice address
8899 University Center LN Ste 200
San Diego, CA 92122-1065
Phone
(858) 224-2281
Fax
(858) 724-3020
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A67126 CA Primary

Addresses

Primary practice location

8899 University Center LN Ste 200
San Diego, CA 92122-1065

Mailing address

8899 University Center LN Ste 200
San Diego, CA 92122-1065
Phone (858) 224-2281

Other names 1

  • Katerina Maria Lent Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67126CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Regents of the University of California PastSince Jun 27, 2018 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kgallus37964@scrippshlth.medalliesdirect.net

Organizations & group practices 2

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1104837129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8899 UNIVERSITY CENTER LN STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221065",
            "telephone_number": "858-224-2281",
            "fax_number": "858-724-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8899 UNIVERSITY CENTER LN STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221065",
            "telephone_number": "858-224-2281",
            "fax_number": "858-724-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLUS",
        "first_name": "KATERINA",
        "middle_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A67126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATERINA",
            "last_name": "LENT",
            "middle_name": "MARIA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.