Individual provider Active NPI

Mary Patricia List, MD

  • Dermatology Physician
  • Roseville, CA
National Provider Identifier
1013440874
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35.148704 Issued in OH
Practice address
2261 Douglas Blvd
Roseville, CA 95661-3831
Phone
(916) 797-4766
NPI assigned
Apr 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35.148704 OH Primary

Addresses

Primary practice location

2261 Douglas Blvd
Roseville, CA 95661-3831

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (800) 470-0071

Other practice location 1

7335 Yankee Rd Ste 202
Liberty Township, OH 45044-1253
Phone (513) 579-9191

Other practice location 2

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 585-0855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230926002119 OH Practitioner - Dermatology 5294066999 Reassigns benefits to 1 organization
I20250820004774 CA Practitioner - Dermatology 5294066999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2261 Douglas Blvd
Roseville, CA 95661-3831
Phone (916) 791-0900

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

Merit-based Incentive Payment System (MIPS)

Final score
90.21 of 100Reported as group
Quality
88
Promoting interoperability
100
Improvement activities
40
Cost
79.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions386
Removal or shaving of skin growth14
Skin biopsy124

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Christ Hospital Medical Associates, LLC CurrentSince Aug 1, 2023 Accepting new patients
Christ Hospital Medical Specialists LLC CurrentSince Oct 16, 2023 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jun 6, 2025 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jun 6, 2025 Accepting new patients
Sutter Valley Medical Foundation Dermatology Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2261 Douglas Blvd
Roseville, CA 95661
Phone (916) 783-1044

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

250 W Main St
Woodland, CA 95695
Phone (916) 668-6100

2123 Auburn Ave
Ste 122
Cincinnati, OH 45219
Phone (513) 381-1400

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

7335 Yankee Rd
Liberty Township, OH 45044
Phone (513) 206-1460

7335 Yankee Rd
Ste 202
Liberty Township, OH 45044
Phone (513) 564-6800

Interoperability endpoints

  • Direct secure messaging: mlist748433@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 1

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": "1491696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1013440874",
    "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",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 DOUGLAS BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613831",
            "telephone_number": "916-797-4766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7335 Yankee Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Liberty Township",
            "state": "OH",
            "postal_code": "450441253",
            "country_code": "US",
            "telephone_number": "513-579-9191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2139 Auburn Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452192906",
            "country_code": "US",
            "telephone_number": "513-585-0855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIST",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-09",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.148704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.