Individual provider Active NPI

Evie Huang, M.D.

  • Pediatrics Physician
  • Los Gatos, CA
National Provider Identifier
1164960878
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A156293 Issued in CA
Practice address
15400 Los Gatos Blvd
Los Gatos, CA 95032-2502
Phone
(408) 523-3640
NPI assigned
Feb 2, 2017
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A156293 CA Primary

Addresses

Primary practice location

15400 Los Gatos Blvd
Los Gatos, CA 95032-2502

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191108002843 CA Practitioner - Pediatric Medicine 1355773599 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A156293CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Oct 1, 2019 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Oct 1, 2019 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Good Samaritan Hospital Ca LTD PTP Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Locations

1501 Trousdale Dr
Burlingame, CA 94010
Phone (650) 696-3520

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

15400 Los Gatos Blvd
Los Gatos, CA 95032
Phone (408) 523-3102

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

1071 Blossom Hill Rd
San Jose, CA 95123
Phone (408) 445-4010

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2128 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 425-0727

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: ehuang464997@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1164960878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 LOS GATOS BLVD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322502",
            "telephone_number": "408-523-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "EVIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A156293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.