Individual provider Active NPI

Leeanne Park, M.D.

  • Anesthesiology Physician
  • Stanford, CA
National Provider Identifier
1730574393
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A146290 Issued in CA
Practice address
300 Pasteur Dr # H3580
Stanford, CA 94305-2200
Phone
(650) 723-7377
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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 A146290 CA
Anesthesiology Physician 207L00000X A146290 CA Primary

Addresses

Primary practice location

300 Pasteur Dr # H3580
Stanford, CA 94305-2200

Mailing address

4750 El Camino Real Apt 120
Los Altos, CA 94022-1353
Phone (570) 417-5437

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
I20190709000789 CA Practitioner - Anesthesiology 6800121179 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

2175 Rosaline Ave
Redding, CA 96001-2549
Phone (530) 225-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A146290CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
County of Santa Clara CurrentSince May 18, 2019 Accepting new patients
County of Santa Clara CurrentSince May 18, 2019 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Jan 1, 2022 Accepting new patients
County of Santa Clara Anesthesiology Current Accepting new patients
County of Santa Clara CurrentSince May 18, 2019 Accepting new patients
County of Santa Clara CurrentSince May 18, 2019 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Jan 1, 2022 Accepting new patients
County of Santa Clara Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2175 Rosaline Ave
Redding, CA 96001
Phone (530) 225-7247

2175 Rosaline Ave
Ste A
Redding, CA 96001
Phone (530) 225-7400

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

300 Pasteur Dr
#H3580
Stanford, CA 94305
Phone (650) 723-6411

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Organizations & group practices 10

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1730574393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 EL CAMINO REAL APT 120",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221353",
            "telephone_number": "570-417-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR # H3580",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "LEEANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A146290",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A146290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.