Individual provider Active NPI

Katherina K.J. Lee

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1396979050
Registry record updated May 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
D4040418 Issued in CA
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(886) 600-2273
NPI assigned
May 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X D4040418 CA Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

5240 Bluemound Rd
Rolling Hills Estates, CA 90274-2304
Phone (310) 378-3101

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
I20150722006246 CA Practitioner - Anesthesiology 2668785452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Rush Medical College of Rush University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
G2 Anesthesia PCGroup PAC ID 3375873599, 104 clinicians

Practice addresses (Care Compare)

2425 Samaritan Dr
San Jose, CA 95124-3908
Phone (408) 559-2011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D4040418CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
G2 Anesthesia PC CurrentSince Jan 1, 2023 Accepting new patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
John Muir Trauma Physicians Billing Service CurrentSince Apr 21, 2017 Accepting new patients

Locations

1720 El Camino Real
Ste 100
Burlingame, CA 94010
Phone (650) 259-5300

429 Llewellyn Ave
Campbell, CA 95008
Phone (408) 358-5000

15047 Los Gatos Blvd
Ste 150
Los Gatos, CA 95032
Phone (408) 356-2244

15047 Los Gatos Blvd
Los Gatos, CA 95032
Phone (408) 356-2774

3468 California St
San Francisco, CA 94118
Phone (415) 345-0100

3370 Geary Blvd
San Francisco, CA 94118
Phone (415) 379-7500

2425 Samaritan Dr
San Jose, CA 95124
Phone (408) 354-2114

100 Park Pl
Ste 200
San Ramon, CA 94583
Phone (925) 867-1800

133 La Casa Via
Ste 150
Walnut Creek, CA 94598
Phone (925) 210-8400

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

100 N Wiget Ln
Ste 140
Walnut Creek, CA 94598
Phone (530) 758-2324

100 N Wiget Ln
Walnut Creek, CA 94598
Phone (530) 758-2324

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

365 Lennon Ln
Ste 100
Walnut Creek, CA 94598
Phone (925) 929-4600

2021 Ygnacio Valley Rd
Ste H102
Walnut Creek, CA 94598
Phone (866) 678-4320

1601 Ygnacio Valley Rd
#100
Walnut Creek, CA 94598
Phone (925) 947-5245

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": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1396979050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 BLUEMOUND RD",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902742304",
            "telephone_number": "310-378-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "886-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KATHERINA",
        "middle_name": "K.J.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "D4040418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.