NPIMap

Individual provider Active NPI

Katherine Marie De Azambuja, MD

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1336672187
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A159349 Issued in CA
Practice address
800 N Main St
Santa Ana, CA 92701-3576
Phone
(657) 282-6355
NPI assigned
Apr 8, 2017
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A159349 CA Primary

Addresses

Primary practice location

800 N Main St
Santa Ana, CA 92701-3576

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-2986

Other practice location 1

101 The City Dr S Bldg 25
Orange, CA 92868-3201
Phone (714) 456-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210802002192 CA Practitioner - Family Practice 7517290588 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University ofGroup PAC ID 3779689518, 30 clinicians
University of California IrvineGroup PAC ID 5395658181, 57 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-8068

800 N Main St
Santa Ana, CA 92701-3576
Phone (714) 456-6324

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
University of California Irvine Current Accepting new patients
University of California Irvine CurrentSince Sep 1, 2021 Accepting new patients
University of California Irvine CurrentSince Sep 1, 2021 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 25
Orange, CA 92868
Phone (714) 456-5731

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

200 S Manchester Ave
Ste 835
Orange, CA 92868
Phone (714) 456-8265

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1491609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1336672187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927013576",
            "telephone_number": "657-282-6355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 The City Dr S Bldg 25",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683201",
            "country_code": "US",
            "telephone_number": "714-456-7007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE AZAMBUJA",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-08",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A159349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.