Active NPI
Kevin Lee Letz, DNP, NP
- Nurse Practitioner
- Palo Alto, CA
National Provider Identifier
1487617064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP17933
- Practice address
- 300 Pasteur Dr
Sumc - Peds Physician Billing MC:5530
Palo Alto, CA 94305-2200 - Phone
- (650) 498-7391
- Fax
- (650) 725-7888
- NPI assigned
- Apr 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP17933 | CA | Primary |
| Family Nurse Practitioner | 363LF0000X | 71000749A | IN | |
| Family Nurse Practitioner | 363LF0000X | AP3102 | AZ |
Addresses
Primary practice location
300 Pasteur Dr
Sumc - Peds Physician Billing MC:5530
Palo Alto, CA 94305-2200
Mailing address
300 Pasteur Dr
Sumc - Peds Physician Billing MC:5530
Palo Alto, CA 94305-2200
Phone (650) 498-7391
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11059766 | Other | CAQH | |
| 500029255 | Other | RAILROAD MEDICARE | |
| 200229520 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP17933 | CA | MD | Nurse Practitioner |
| AP3102 | AZ | MD | Family Nurse Practitioner |
| 71000749A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine of Indiana | Past | Accepting new patients | |
| Bull Chiropractic, P.C. | Past | Accepting new patients | |
| Precision Cardio Pulmonary, LLC | Past | Accepting new patients | |
| Phoenix Emergency Services of Madison LLC | Nurse Practitioner | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Adult Health Nurse Practitioner
- Sacramento, CA
- NPI 1053649293
-
- Chiropractor
- Fort Wayne, IN
- NPI 1013106905
-
- Emergency Medicine Physician
- Fort Wayne, IN
- NPI 1952356883
-
- Emergency Medicine Physician
- Madison, IN
- NPI 1881683548
Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270684800000",
"number": "1487617064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"address_2": "SUMC - PEDS PHYSICIAN BILLING MC:5530",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-498-7391",
"fax_number": "650-725-7888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"address_2": "SUMC - PEDS PHYSICIAN BILLING MC:5530",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-498-7391",
"fax_number": "650-725-7888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LETZ",
"first_name": "KEVIN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DNP, NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-06",
"last_updated": "2010-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NP17933",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71000749A",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP3102",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11059766",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500029255",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200229520",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.