Individual provider Active NPI

Harace Samuel Bangah, NP

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1013759042
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029991 Issued in CA
Practice address
1201 Alhambra Blvd Ste 300
Sacramento, CA 95816-5241
Phone
(916) 451-4400
NPI assigned
Jun 11, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 95029991 CA Primary

Addresses

Primary practice location

1201 Alhambra Blvd Ste 300
Sacramento, CA 95816-5241

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241209002410 CA Practitioner - Nurse Practitioner 7810423290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
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)

16911 Willow Glen Rd
Brownsville, CA 95919-9707
Phone (530) 675-2457

2800 L St
Sacramento, CA 95816-5616

440 Plumas Blvd
Yuba City, CA 95991-5071
Phone (530) 749-3409

444 Plumas Blvd
Yuba City, CA 95991-5071
Phone (530) 749-3420

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95029991CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Multi-Specialty Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Oct 1, 2024 Accepting new patients
Sutter Valley Medical Foundation Multi-Specialty CurrentSince Oct 1, 2024 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

635 Anderson Rd
Ste 10
Davis, CA 95616
Phone (530) 758-1122

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

1201 Alhambra Blvd
Ste 300
Sacramento, CA 95816
Phone (916) 451-4400

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

Interoperability endpoints

  • Direct secure messaging: hbangah589982@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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 2

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": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1013759042",
    "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": "1201 ALHAMBRA BLVD STE 300",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165241",
            "telephone_number": "916-451-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGAH",
        "first_name": "HARACE",
        "middle_name": "SAMUEL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.