Individual provider Active NPI

Sara E. Stagg, MD

  • Emergency Medicine Physician
  • Culver City, CA
National Provider Identifier
1053426056
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G47930 Issued in CA
Practice address
3828 Delmas Ter
Culver City, CA 90232-2713
Phone
(310) 836-7000
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G47930 CA Primary

Addresses

Primary practice location

3828 Delmas Ter
Culver City, CA 90232-2713

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2600

Other identifiers 1

IdentifierTypeStateIssuer
00G479300MedicaidCA

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
I20090709000775 CA Practitioner - Emergency Medicine 7214095785 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G47930CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Jul 1, 2011 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jun 1, 2009 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jun 1, 2009 Accepting new patients
Travis W. Martin, M.D. P.C. Emergency Medicine Past Accepting new patients

Locations

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

751 Medical Center Ct
#1182
Chula Vista, CA 91911

3828 Delmas Ter
Culver City, CA 90232
Phone (310) 202-4745

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1025 N Douty St
Hanford, CA 93230
Phone (559) 537-0170

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1141 Rose Ave
Selma, CA 93662
Phone (559) 790-2800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1053426056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 DELMAS TER",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322713",
            "telephone_number": "310-836-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGG",
        "first_name": "SARA",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G47930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G479300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.