Individual provider Active NPI

Kathleen M. Ting, MD

  • MOHS-Micrographic Surgery Physician
  • Walnut Creek, CA
National Provider Identifier
1407934599
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
C51669 Issued in CA
Practice address
320 Lennon LN
Walnut Creek, CA 94598-2419
Phone
(925) 906-2000
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X C51669 CA Primary

Addresses

Primary practice location

320 Lennon LN
Walnut Creek, CA 94598-2419

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3466
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00C516690MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20041209000561 CA Practitioner - Dermatology 3274500061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

801 S Ham LN
Suite a
Lodi, CA 95242-7502
Phone (209) 333-3376

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision35
Removal of tissue1-10
Removal of skin lesions1-10
Removal of skin cancer273
Skin biopsy17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C51669CAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
Golden State Dermatology Associates, Inc. CurrentSince May 16, 2023 Accepting new patients
Permanente Medical Group, Inc CurrentSince Sep 16, 2021 Accepting new patients
Golden State Dermatology Associates, Inc. Mohs-Micrographic Surgery CurrentSince May 16, 2023 Accepting new patients
Permanente Medical Group Inc CurrentSince Sep 16, 2021 Accepting new patients
University Dermatologists Inc Past Accepting new patients
John Muir Health Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Swedishamerican Hospital Past Accepting new patients

Locations (25 of 28)

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2320 Woolsey St
Ste 202
Berkeley, CA 94705
Phone (510) 486-1700

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1074 Murrieta Blvd
Livermore, CA 94550
Phone (925) 277-1300

801 S Ham Ln
Ste A
Lodi, CA 95242
Phone (209) 333-3376

388 E Yosemite Ave
Ste 100
Merced, CA 95340
Phone (209) 383-3456

1324 Nelson Ave
Ste B
Modesto, CA 95350
Phone (209) 524-9481

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

5601 J St
Sacramento, CA 95819
Phone (916) 454-5922

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2625 Fair Oaks Blvd
Ste 1
Sacramento, CA 95864
Phone (916) 646-3376

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

280 Baldwin Ave
San Mateo, CA 94401
Phone (650) 344-1121

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

1542 N Tracy Blvd
#A
Tracy, CA 95376
Phone (209) 836-2220

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 Lennon Ln
Walnut Creek, CA 94598
Phone (925) 906-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1407934599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 LENNON LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982419",
            "telephone_number": "925-906-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TING",
        "first_name": "KATHLEEN",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "C51669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C516690",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "320 Lennon Ln",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945982419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.