Individual provider Active NPI

Theodore WC Brenton, NP

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1033696315
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009430 Issued in CA
Practice address
4501 X Street
Sacramento, CA 95817-2229
Phone
(916) 734-5981
Fax
(916) 734-0631
NPI assigned
Jul 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009430 CA Primary

Addresses

Primary practice location

4501 X Street
Sacramento, CA 95817-2229

Mailing address

4501 X Street
Suite 3016
Sacramento, CA 95817-2229
Phone (916) 734-3772

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
I20180918000171 CA Practitioner - Nurse Practitioner 5092066969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone (916) 734-2680

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95009430CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Oct 1, 2021 Accepting new patients
Regents of the Univ of Ca CurrentSince Oct 1, 2021 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

3850 G St
Merced, CA 95340
Phone (209) 384-6528

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

4501 X St
Fl 2
Sacramento, CA 95817
Phone (916) 734-5959

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

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

4501 X St
Sacramento, CA 95817
Phone (916) 734-5959

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

4501 X St
Ste 3016
Sacramento, CA 95817
Phone (916) 734-3771

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 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": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1033696315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 X STREET",
            "address_2": "SUITE 3016",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172229",
            "telephone_number": "916-734-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 X STREET",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172229",
            "telephone_number": "916-734-5981",
            "fax_number": "916-734-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENTON",
        "first_name": "THEODORE",
        "middle_name": "WC",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-19",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.