NPIMap

Individual provider Active NPI

Katrina Elizabeth Lettang, MD

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1689238255
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
65612 Issued in AZ
Practice address
Maricopa Integrated Health System
2601 E Roosevelt St.
Phoenix, AZ 85008-4973
Phone
(602) 344-5011
NPI assigned
Apr 29, 2019
Last updated
May 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 65612 AZ Primary

Addresses

Primary practice location

Maricopa Integrated Health System
2601 E Roosevelt St.
Phoenix, AZ 85008-4973

Mailing address

Maricopa Integrated Health System
2601 E Roosevelt St.
Phoenix, AZ 85008-4973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220505002284 AZ Practitioner - Emergency Medicine 0446637748 Reassigns benefits to 3 organizations
I20240215003146 TX Practitioner - Emergency Medicine 0446637748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians
Tec Emergency Physicians of Arizona, LLCGroup PAC ID 6204256084, 155 clinicians

Practice addresses (Care Compare)

103 Medicine Way Rd
Peridot, AZ 85542-0787
Phone (928) 475-1400

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

7171 S 51St Ave
Laveen, AZ 85339-2923
Phone (888) 732-3317

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.18 of 100Reported as group
Quality
61.12
Improvement activities
40
Cost
81.87

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65612AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Emergency Medicine CurrentSince May 20, 2022 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jan 13, 2024 Accepting new patients
Tec Emergency Physicians of Arizona, LLC CurrentSince Jul 1, 2022 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Oct 23, 2024 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Cep America - Arizona PC Emergency Medicine CurrentSince May 1, 2023 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Oct 23, 2024 Accepting new patients
Cep America- Arizona, PC Emergency Medicine CurrentSince May 1, 2023 Accepting new patients
District Medical Group, Inc CurrentSince May 20, 2022 Accepting new patients

Locations

7171 S 51st Ave
Laveen, AZ 85339
Phone (623) 584-5100

9130 E Elliot Rd
Mesa, AZ 85212
Phone (480) 410-4500

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Interoperability endpoints

  • Direct secure messaging: klettang201762@direct.valleywisehealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1689238255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MARICOPA INTEGRATED HEALTH SYSTEM",
            "address_2": "2601 E ROOSEVELT ST.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARICOPA INTEGRATED HEALTH SYSTEM",
            "address_2": "2601 E ROOSEVELT ST.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTANG",
        "first_name": "KATRINA",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "65612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.