Individual provider Active NPI

Katherine Laura Widnell, MD, PHD

  • Neurology Physician
  • Burbank, CA
National Provider Identifier
1295777100
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
C141716 Issued in CA
Practice address
2625 W Alameda Ave Ste 322
Burbank, CA 91505-4822
Phone
(818) 843-9043
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X C141716 CA Primary

Addresses

Primary practice location

2625 W Alameda Ave Ste 322
Burbank, CA 91505-4822

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
34632300MedicaidWI

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
I20220105000639 CA Practitioner - Neurology 9830155639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Yale University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19191 S Vermont Ave
FL 7 Business Office
Torrance, CA 90502-1018

5767 W Century Blvd
Los Angeles, CA 90045-5631

Hospital & facility affiliations

  • Sunny Days Home Care, Inc. Home health agency, Glendale, CA, CCN 757017
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Ridgecrest Regional Hospital Hospital, Ridgecrest, CA, CCN 051333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C141716CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Nov 8, 2021 Accepting new patients
Regents of the University of California Los Angeles Neurology CurrentSince Nov 1, 2023 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Nov 8, 2021 Accepting new patients
Healthcare Partners Affiliates Medical Group Current Accepting new patients
Wi Institute for Neurologic & Sleep Disorders, SC Past Accepting new patients
UCLA Medical Group Neurology Past Accepting new patients
Wichita Parkinson'S Center, LLC Neurology PastSince Jul 30, 2007 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2625 W Alameda Ave
Ste 322
Burbank, CA 91505
Phone (818) 843-9015

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

1801 Wilshire Blvd
Santa Monica, CA 90403
Phone (310) 319-5098

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

32144 Agoura Rd
Ste 100
Westlake Village, CA 91361
Phone (805) 557-7180

Organizations & group practices 7

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 5

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1295777100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 W ALAMEDA AVE STE 322",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054822",
            "telephone_number": "818-843-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDNELL",
        "first_name": "KATHERINE",
        "middle_name": "LAURA",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "C141716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34632300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.