NPIMap

Individual provider Active NPI

Katie Kenefick Crean-Tate, M.D.

  • Obstetrics & Gynecology Physician
  • Sacramento, CA
National Provider Identifier
1811293780
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A133238 Issued in CA
Practice address
2800 L St Ste 300
Sacramento, CA 95816-5616
Phone
(916) 733-4440
NPI assigned
Feb 9, 2011
Last updated
Aug 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 130754 OH
Obstetrics & Gynecology Physician 207V00000X A133238 CA Primary

Addresses

Primary practice location

2800 L St Ste 300
Sacramento, CA 95816-5616

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200827002548 CA Practitioner - Gynecological Oncology 7618249582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133238CAMDObstetrics & Gynecology Physician
130754OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation Obstetrics & Gynecology CurrentSince Sep 21, 2020 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Sep 21, 2020 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter Regional Medical Foundation Obstetrics & Gynecology Past Accepting new patients

Locations

2800 L St
Ste 300
Sacramento, CA 95816
Phone (916) 453-3300

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: kcreantate551641@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 7

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": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1811293780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 L ST STE 300",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165616",
            "telephone_number": "916-733-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREAN-TATE",
        "first_name": "KATIE",
        "middle_name": "KENEFICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-09",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "130754",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A133238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.