Individual provider Active NPI

Ignacio Cortina Petrasic

  • Internal Medicine Physician
  • Sacramento, CA
National Provider Identifier
1043870942
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A184391 Issued in CA
Practice address
4610 X St
Sacramento, CA 95817-2200
Phone
(916) 734-2011
NPI assigned
Jun 13, 2019
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A184391 CA Primary

Addresses

Primary practice location

4610 X St
Sacramento, CA 95817-2200

Mailing address

2315 Stockton Blvd Ste 2P101
Sacramento, CA 95817-2201
Phone (916) 734-7506

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
I20241030000908 CA Practitioner - Internal Medicine 0840670972 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Davis School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

4501 X St
Sacramento, CA 95817-2229
Phone (916) 734-5959

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A184391CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca Internal Medicine CurrentSince Oct 7, 2024 Accepting new patients
County of Sacramento CurrentSince Nov 1, 2024 Accepting new patients
Regents of the Univ of Ca CurrentSince Oct 7, 2024 Accepting new patients
County of Sacramento CurrentSince Nov 1, 2024 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2315 Stockton Blvd
Ste 2P101
Sacramento, CA 95817
Phone (916) 734-7506

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

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

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

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

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 400
Sacramento, CA 95817
Phone (916) 734-1482

Interoperability endpoints

  • Direct secure messaging: icortinapetrasic346329@direct.ochin.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1043870942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD STE 2P101",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172200",
            "telephone_number": "916-734-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTINA PETRASIC",
        "first_name": "IGNACIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A184391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.