Individual provider Active NPI

Katherine Footracer, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1265688337
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21069 Issued in CA
Practice address
1520 San Pablo St Ste 1300
Los Angeles, CA 90033-5312
Phone
(323) 442-5900
NPI assigned
Aug 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00202000 NJ
Physician Assistant 363A00000X PA21069 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 1300
Los Angeles, CA 90033-5312

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address katherine.footracer@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000176 CA Practitioner - Physician Assistant 1759563018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

Hospital & facility affiliations

  • Usc Verdugo Hills Hospital Hospital, Glendale, CA, CCN 050124
  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660
  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA21069CAMDPhysician Assistant
25MP00202000NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2021 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2021 Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1808 Verdugo Blvd
Ste 112
Glendale, CA 91208
Phone (818) 949-7380

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1520 San Pablo St
Ste 1300
Los Angeles, CA 90033
Phone (323) 442-5900

625 S Fair Oaks Ave
Ste 400
Pasadena, CA 91105
Phone (626) 568-1622

Interoperability endpoints

  • Direct secure messaging: katherine.footracer@direct.usc.edu
  • Direct secure messaging: katherine.footracer.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 6

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.

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": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1265688337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 1300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335312",
            "telephone_number": "323-442-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTRACER",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00202000",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katherine.footracer@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St Ste 1300",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.