Active NPI
Kaitlin Lee Shruhan, RD
- Registered Dietitian
- Palo Alto, CA
National Provider Identifier
1770060642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86058052
- Practice address
- 725 Welch Rd
Palo Alto, CA 94304-1601 - Phone
- (650) 497-8000
- NPI assigned
- Jul 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86058052 | CA | Primary |
Addresses
Primary practice location
725 Welch Rd
Palo Alto, CA 94304-1601
Mailing address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000
Other practice location 1
3600 Broadway
Oakland, CA 94611-5730
Phone (510) 752-1000
Other practice location 2
3600 Broadway
Oakland, CA 94611-5730
Phone (510) 752-1000
Other names 1
- Kaitlin Lee Barragan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86058052 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts General Physicians Organization Inc | Current | Accepting new patients | |
| The General Hospital Corporation | Current | Accepting new patients |
Locations
55 Fruit St
Boston, MA 02114
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
62 13th St
Ste 102
Charlestown, MA 02129
Organizations & group practices 2
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.
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679011200000",
"number": "1770060642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8000"
}
],
"practiceLocations": [
{
"address_1": "3600 Broadway",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946115730",
"country_code": "US",
"telephone_number": "510-752-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3600 Broadway",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946115730",
"country_code": "US",
"telephone_number": "510-752-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHRUHAN",
"first_name": "KAITLIN",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-24",
"last_updated": "2023-03-17",
"certification_date": "2023-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86058052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAITLIN",
"last_name": "BARRAGAN",
"middle_name": "LEE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.