Organization Active NPI

Katherine M Federle DC Acpc

  • Exclusive Provider Organization
  • Menlo Park, CA
National Provider Identifier
1982858635
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
15196 Issued in CA
Legal business name
KATHERINE M FEDERLE DC ACPC
Practice address
630 Oak Grove Ave
Menlo Park, CA 94025-4318
Phone
(650) 323-6294
Fax
(650) 324-9898
NPI assigned
Nov 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2008

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

Authorized official

Name
Mrs. Yee Ping Wu Ching
Title
Office Manager
Phone
(650) 323-6294

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 15196 CA Primary

Addresses

Primary practice location

630 Oak Grove Ave
Menlo Park, CA 94025-4318

Mailing address

630 Oak Grove Ave
Menlo Park, CA 94025-4318
Phone (650) 323-6294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081118000341 CA Part B Supplier - Clinic/Group Practice 2466512652 Receives reassigned benefits from 1 practitioner
Practice locations: Redwood City, CA

National Provider Directory

National Provider Directory

Locations

630 Oak Grove Ave
Menlo Park, CA 94025
Phone (650) 323-6294

950 Woodside Rd
Ste 1
Redwood City, CA 94061
Phone (650) 599-9470

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226016000000",
    "number": "1982858635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 OAK GROVE AVE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254318",
            "telephone_number": "650-323-6294",
            "fax_number": "650-324-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 OAK GROVE AVE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254318",
            "telephone_number": "650-323-6294",
            "fax_number": "650-324-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE M FEDERLE DC ACPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-07",
        "last_updated": "2008-11-07",
        "status": "A",
        "authorized_official_last_name": "CHING",
        "authorized_official_first_name": "YEE PING",
        "authorized_official_middle_name": "WU",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "650-323-6294",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "15196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.

Verify at the official NPI Registry.