Individual provider Active NPI

Kevin Lee Letz, DNP, NP

  • Nurse Practitioner
  • Palo Alto, CA
National Provider Identifier
1487617064
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP17933 Issued in CA
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

Updated by the provider on Apr 8, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
11059766OtherCAQH
500029255OtherRAILROAD MEDICARE
200229520MedicaidIN

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

LicenseStateTypeSpecialty
NP17933CAMDNurse Practitioner
AP3102AZMDFamily Nurse Practitioner
71000749AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.