Individual provider Active NPI

Denise L. Martin-Sahim, AUD

  • Specialist
  • Fairfield, CA
National Provider Identifier
1023182425
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
680233061 Issued in CA
Practice address
1700 Pennsylvania Ave Ste B
Fairfield, CA 94533-3510
Phone
(707) 426-4327
Fax
(707) 426-5190
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 680233061 CA Primary

Addresses

Primary practice location

1700 Pennsylvania Ave Ste B
Fairfield, CA 94533-3510

Mailing address

1700 Pennsylvania Ave Ste B
Fairfield, CA 94533-3510
Phone (707) 426-4327

Other identifiers 1

IdentifierTypeStateIssuer
HA0023830MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000586 CA Practitioner - Qualified Audiologist 6800054206 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pine River Inc. CurrentSince Jan 1, 2018 Accepting new patients
Pine River Inc PastSince Mar 30, 2019 Accepting new patients
Sound Hearing Services Past Accepting new patients
Pine River, Inc. Past Accepting new patients

Locations

1620 Pennsylvania Ave
Ste D
Fairfield, CA 94533
Phone (707) 421-2229

1700 Pennsylvania Ave
Ste B
Fairfield, CA 94533
Phone (707) 426-4327

673 Merchant St
Ste B
Vacaville, CA 95688
Phone (707) 426-0742

480 Redwood St
Ste 14
Vallejo, CA 94590
Phone (707) 642-2111

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1023182425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 PENNSYLVANIA AVE STE B",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333510",
            "telephone_number": "707-426-4327",
            "fax_number": "707-426-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PENNSYLVANIA AVE STE B",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333510",
            "telephone_number": "707-426-4327",
            "fax_number": "707-426-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-SAHIM",
        "first_name": "DENISE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "680233061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HA0023830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.