Individual provider Active NPI

Leslie Sue, D.O.

  • Pediatrics Physician
  • Redwood City, CA
National Provider Identifier
1174665673
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A8682 Issued in CA
Practice address
801 Brewster Ave Ste 175
Redwood City, CA 94063-1559
Phone
(650) 216-7794
Fax
(650) 216-7796
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 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 20A8682 CA Primary

Addresses

Primary practice location

801 Brewster Ave Ste 175
Redwood City, CA 94063-1559

Mailing address

801 Brewster Ave Ste 175
Redwood City, CA 94063-1559
Phone (650) 216-7794

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A8682CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Health Medical Foundation Past Accepting new patients
Children'S Hospital & Research Center at Oakland Past Accepting new patients
Sequoia Health Services Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1174665673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BREWSTER AVE STE 175",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631559",
            "telephone_number": "650-216-7794",
            "fax_number": "650-216-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BREWSTER AVE STE 175",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631559",
            "telephone_number": "650-216-7794",
            "fax_number": "650-216-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUE",
        "first_name": "LESLIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A8682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.