Individual provider Active NPI

Carrie Wesenberg Loutit, MD

  • Pediatrics Physician
  • Palo Alto, CA
National Provider Identifier
1366577785
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A45931 Issued in CA
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 497-8000
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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 A45931 CA Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000

Other identifiers 1

IdentifierTypeStateIssuer
00A459310MedicaidCA

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
I20070511000576 CA Practitioner - Pediatric Medicine 7214034024 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45931CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Jan 15, 2011 Accepting new patients

Locations

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

Interoperability endpoints

  • Direct secure messaging: cloutit578439@direct.ochin.org

Organizations & group practices 1

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1366577785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUTIT",
        "first_name": "CARRIE",
        "middle_name": "WESENBERG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A45931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A459310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.