KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC) – Family Nurse Practitioner, NPI 1053604462

KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC) is a healthcare provider. based in Studio city, California. specializing in NURSE PRACTITIONER. They hold the professional credentials RN, MSN, FNP-BC. They hold a License No. NP19625 (CA). The NPI Number for KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC) is 1053604462

Main info

Female
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC)
NPI
1053604462
Phone
(912) 844-2772
Address
4121 RADFORD AVE APT 216
Enumeration Date
18 May 2011
Last Update Date
18 May 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1998 (28 years ago)
PAC ID
1951735562
Group Practice PAC ID
5991897845
Professional Enrollment ID
I20200107000510
Address ID
CA913561411Ta18646STXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC)

  • 4121 RADFORD AVE APT 216

    STUDIO CITY, CA 916042178

    Phone: (912) 844-2772

    Type: Mailing

  • 11301 WILSHIRE BLVD

    LOS ANGELES, CA 900731003

    Phone: (310) 268-3295

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $150.

Total Amount is formed as General ($150) + Research ($0) + Ownership ($0) = $150.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($150).

Total Amount

$150

General + Research + Ownership

Payments

1

Total payment records

General Amount

$150

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-01-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200107000510INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91604)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991897845View full group profile
NameSpecialtyState
-CA
Nurse PractitionerCA
Pain Management, Physical Medicine And RehabilitationCA
Nurse PractitionerCA
Clinical Social WorkerCA
-CA
Physician AssistantCA
P S Y C H I A T R YCA
Marriage And Family TherapistCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

Is there an official ID for KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC) in U.S. healthcare records?
The official identifier for KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC) is NPI 1053604462.
Is KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC) shown as active in public data?
Registry records indicate KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC) maintains an active NPI.
How would a patient describe KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC)'s focus?
For KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC), the primary taxonomy reads as Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC)?
Travel planning: use Studio City, California as the reference point for KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC), then confirm.
Does KATHERINE KANE SUTLIVE (RN, MSN, FNP-BC) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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