Individual provider Active NPI

Kathleen Lo, MD

  • Pediatric Gastroenterology Physician
  • Los Gatos, CA
National Provider Identifier
1770018640
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
A157577 Issued in CA
Practice address
14651 S Bascom Ave Ste 110
Los Gatos, CA 95032-2004
Phone
(408) 358-3573
NPI assigned
Apr 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Gastroenterology Physician 2080P0206X A157577 CA Primary
Pediatrics Physician 208000000X A157577 CA

Addresses

Primary practice location

14651 S Bascom Ave Ste 110
Los Gatos, CA 95032-2004

Mailing address

14651 S Bascom Ave Ste 110
Los Gatos, CA 95032-2004
Phone (408) 358-3573

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
I20200618000913 CA Practitioner - Pediatric Medicine 7113349200 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157577CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Oct 6, 2024 Accepting new patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Jun 18, 2024 Accepting new patients
Stanford Health Care CurrentSince Oct 6, 2024 Accepting new patients
Stanford Health Care Pediatrics Current Accepting new patients

Locations

824 Bay Ave
Ste 70
Capitola, CA 95010
Phone (831) 464-6200

14651 S Bascom Ave
Ste 110
Los Gatos, CA 95032
Phone (408) 356-8681

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

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": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1770018640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14651 S BASCOM AVE STE 110",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322004",
            "telephone_number": "408-358-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14651 S BASCOM AVE STE 110",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322004",
            "telephone_number": "408-358-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "A157577",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A157577",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.