Individual provider Active NPI

Julia Regina Katsuura, MD

  • Pediatrics Physician
  • Ukiah, CA
National Provider Identifier
1679816938
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
170569 Issued in CA
Practice address
260 Hospital Dr Ste 204
Ukiah, CA 95482-4568
Phone
(707) 463-7459
NPI assigned
Apr 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 54442 TN
Pediatrics Physician 208000000X 170569 CA Primary

Addresses

Primary practice location

260 Hospital Dr Ste 204
Ukiah, CA 95482-4568

Mailing address

260 Hospital Dr Ste 204
Ukiah, CA 95482-4568
Phone (707) 463-7459

Other names 1

  • Julia Regia Pollock Former name

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
I20201204002445 CA Practitioner - Pediatric Medicine 9335380757 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170569CAMDPediatrics Physician
54442TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mendocino Community Health Clinic, Inc. CurrentSince Oct 22, 2022 Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince Oct 22, 2022 Accepting new patients
University of California, San Francisco Past Accepting new patients
Golden Gate Pediatrics, a Medical Corporation Pediatrics Past Accepting new patients

Locations

333 Laws Ave
Ukiah, CA 95482
Phone (707) 463-1113

Interoperability endpoints

  • Direct secure messaging: jkatsura@ggp.pcc-direct.com
  • Direct secure messaging: jkatsuura526228@direct.ochin.org
  • Direct secure messaging: jkatsuura662200@hisp.ehr.sutterhealth.org

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1679816938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 204",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-463-7459",
            "fax_number": "423-778-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 204",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-463-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATSUURA",
        "first_name": "JULIA",
        "middle_name": "REGINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "54442",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "170569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "POLLOCK",
            "middle_name": "REGIA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.