Individual provider Active NPI

Jennifer Katzenberg

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
National Provider Identifier
1134645732
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
149913 Issued in CA
Practice address
424 S 56TH St Ste 120
Phoenix, AZ 85034-2177
Phone
(602) 685-5211
Fax
(602) 685-5373
NPI assigned
Aug 16, 2017
Last updated
Jul 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 149913 CA Primary

Addresses

Primary practice location

424 S 56TH St Ste 120
Phoenix, AZ 85034-2177

Mailing address

PO Box 42210
Phoenix, AZ 85080-2210
Phone (623) 266-7770

Other practice location 1

10833 Le Conte Ave # Chsas
Los Angeles, CA 90095-3075
Phone (310) 267-2625

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220822000801 AZ Practitioner - Pathology 7012240286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Arizona College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Specialist of Arizona, LLPGroup PAC ID 4789583188, 69 clinicians

Practice addresses (Care Compare)

424 S 56TH St
Suite 120
Phoenix, AZ 85034-2177
Phone (602) 685-5211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.75 of 100Reported as group
Quality
75
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Specialist of Arizona, LLP Anatomic Pathology & Clinical Pathology CurrentSince Oct 1, 2022 Accepting new patients
Sonoran Radiology LTD PastSince Jul 24, 2022 Accepting new patients
Tucson Pathology Associates P.C. Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

424 S 56th St
Ste 120
Phoenix, AZ 85034
Phone (480) 478-8059

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

7350 E Speedway Blvd
Ste 101
Tucson, AZ 85710

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1134645732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850802210",
            "telephone_number": "623-266-7770",
            "fax_number": "623-322-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 S 56TH ST STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342177",
            "telephone_number": "602-685-5211",
            "fax_number": "602-685-5373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10833 Le Conte Ave # Chsas",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953075",
            "country_code": "US",
            "telephone_number": "310-267-2625",
            "fax_number": "310-267-3561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATZENBERG",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "149913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.