Active NPI
Jacqueline Kathleen Lekostaj, M.D., PH.D.
- Molecular Genetic Pathology (Pathology) Physician
- Carlsbad, CA
National Provider Identifier
1659692317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Molecular Genetic Pathology (Pathology) Physician
- License
- A137006
- Practice address
- 2110 Rutherford Rd
San03-1051
Carlsbad, CA 92008-7328 - Phone
- (760) 516-5113
- NPI assigned
- Jun 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Molecular Genetic Pathology (Pathology) Physician | 207ZP0007X | A137006 | CA | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 036132840 | IL |
Addresses
Primary practice location
2110 Rutherford Rd
San03-1051
Carlsbad, CA 92008-7328
Mailing address
2110 Rutherford Rd
San03-1051
Carlsbad, CA 92008-7328
Phone (760) 516-5113
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A137006 | Other | CA | MEDICAL BOARD OF CALIFORNIA |
| 125057763 | Other | IL | MEDICAL LICENSE, TEMPORARY |
| 036132840 | Other | IL | MEDICAL LICENSE, PERMANENT |
| MD-41874 | Other | IA | IOWA BOARD OF MEDICINE |
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
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A137006 | CA | MD | Molecular Genetic Pathology (Pathology) Physician |
| 036132840 | IL | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446508800000",
"number": "1659692317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 RUTHERFORD RD",
"address_2": "SAN03-1051",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920087328",
"telephone_number": "760-516-5113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 RUTHERFORD RD",
"address_2": "SAN03-1051",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920087328",
"telephone_number": "760-516-5113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEKOSTAJ",
"first_name": "JACQUELINE",
"middle_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-17",
"last_updated": "2015-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0007X",
"taxonomy_group": "",
"desc": "Pathology, Molecular Genetic Pathology",
"state": "CA",
"license": "A137006",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IL",
"license": "036132840",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL BOARD OF CALIFORNIA",
"identifier": "A137006",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE, TEMPORARY",
"identifier": "125057763",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE, PERMANENT",
"identifier": "036132840",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA BOARD OF MEDICINE",
"identifier": "MD-41874",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.