Individual provider Active NPI

Lisa Nalani Mika Rasmussen, M.D.

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1023422292
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A143161 Issued in CA
Practice address
2516 Stockton Blvd
Pediatric Residency Program
Sacramento, CA 95817-2208
Phone
(916) 734-2428
NPI assigned
Jun 16, 2014
Last updated
Jun 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X A143161 CA Primary

Addresses

Primary practice location

2516 Stockton Blvd
Pediatric Residency Program
Sacramento, CA 95817-2208

Mailing address

2516 Stockton Blvd
Pediatric Residency Program
Sacramento, CA 95817-2208
Phone (916) 734-2428

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170706000770 CA Practitioner - Pediatric Medicine 9234408378 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
143161CAMDMarriage & Family Therapist
A143161CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
County of Sacramento CurrentSince Aug 1, 2017 Accepting new patients
Regents of the University of Ca Pediatrics CurrentSince Jul 1, 2017 Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 1, 2017 Accepting new patients
County of Sacramento CurrentSince Aug 1, 2017 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
UC Davis Health Systems Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

2521 Stockton Blvd
Ste 2200
Sacramento, CA 95817
Phone (916) 734-2105

4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670

4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

Interoperability endpoints

  • Direct secure messaging: lrasmussen213064@direct.ochin.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1023422292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "address_2": "PEDIATRIC RESIDENCY PROGRAM",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "address_2": "PEDIATRIC RESIDENCY PROGRAM",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSSEN",
        "first_name": "LISA",
        "middle_name": "NALANI MIKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A143161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.