Individual provider Active NPI

Samuel Katz, M.D.

  • Emergency Medicine Physician
  • San Ramon, CA
National Provider Identifier
1447469424
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G69003 Issued in CA
Practice address
6001 Norris Canyon Rd
San Ramon, CA 94583-5400
Phone
(925) 275-8282
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G69003 CA Primary

Addresses

Primary practice location

6001 Norris Canyon Rd
San Ramon, CA 94583-5400

Mailing address

2057 Magnolia Way
Walnut Creek, CA 94595-1629

Other identifiers 2

IdentifierTypeStateIssuer
G69003OtherCASTATE LICENSE
00G690030MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040519001382 CA Practitioner - Emergency Medicine 1052302916

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G69003CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Ramon Regional Medical Center Past Accepting new patients

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229558400000",
    "number": "1447469424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2057 MAGNOLIA WAY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945951629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 NORRIS CANYON RD",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835400",
            "telephone_number": "925-275-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G69003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G69003",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G690030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.