Individual provider Active NPI

Kathryn C Stephens

  • Psychiatry Physician
  • Palo Alto, CA
National Provider Identifier
1720646490
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A183066 Issued in CA
Practice address
4139 El Camino Way
Palo Alto, CA 94306-4010
Phone
(669) 319-2687
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-13591 AR
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X A183066 CA Primary

Addresses

Primary practice location

4139 El Camino Way
Palo Alto, CA 94306-4010

Mailing address

401 Quarry Rd
Palo Alto, CA 94304-1419
Phone (650) 721-4408

Other practice location 1

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5000

Other practice location 2

10025 W Markham St Ste 210
Little Rock, AR 72205-2178
Phone (501) 663-5473

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
I20221230000480 CA Practitioner - Psychiatry 1658782016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Arkansas College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Momentum for HealthGroup PAC ID 2769377217, 41 clinicians

Practice addresses (Care Compare)

2001 The Alameda
San Jose, CA 95126-1136
Phone (408) 938-6750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-13591ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum for Health Current Accepting new patients
Momentum for Health CurrentSince Dec 19, 2022 Accepting new patients
Momentum for Mental Health CurrentSince Dec 19, 2022 Accepting new patients

Locations

438 N White Rd
San Jose, CA 95127
Phone (408) 254-6828

2001 The Alameda
San Jose, CA 95126
Phone (408) 938-6750

1922 The Alameda
Ste 316
San Jose, CA 95126
Phone (408) 637-0341

Interoperability endpoints

  • Direct secure messaging: kathryn.stephens@direct.myhealthep.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1720646490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 QUARRY RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041419",
            "telephone_number": "650-721-4408",
            "fax_number": "650-725-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 EL CAMINO WAY",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943064010",
            "telephone_number": "669-319-2687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052707",
            "country_code": "US",
            "telephone_number": "915-215-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10025 W Markham St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722052178",
            "country_code": "US",
            "telephone_number": "501-663-5473",
            "fax_number": "501-801-1816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "KATHRYN",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-13591",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A183066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.