Individual provider Active NPI

Andrew Jay Katz, M.D.

  • Pediatrics Physician
  • Elk Grove, CA
National Provider Identifier
1932131257
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A81324 Issued in CA
Practice address
8220 Wymark Drive
Suite 200
Elk Grove, CA 95757-0000
Phone
(916) 667-0600
Fax
(916) 683-0232
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A81324 CA Primary

Addresses

Primary practice location

8220 Wymark Drive
Suite 200
Elk Grove, CA 95757-0000

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956
Phone (916) 861-1451

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
I20040818000521 CA Practitioner - Pediatric Medicine 5395718241 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81324CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Sep 13, 2020 Accepting new patients
Dignity Health Medical Foundation CurrentSince Sep 13, 2020 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

1264 Hawks Flight Ct
Ste 100
El Dorado Hills, CA 95762
Phone (916) 933-4222

8220 Wymark Dr
Ste 200
Elk Grove, CA 95757
Phone (916) 667-0600

7911 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3950

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

Organizations & group practices 6

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1932131257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-861-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 WYMARK DRIVE",
            "address_2": "SUITE 200",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957570000",
            "telephone_number": "916-667-0600",
            "fax_number": "916-683-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "ANDREW",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A81324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.