Individual provider Active NPI

Mary Annelise Rasmussen

  • Pediatric Rehabilitation Medicine Physician
  • Sacramento, CA
National Provider Identifier
1073074290
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
License
A180647 Issued in CA
Practice address
4860 Y St Ste 3850
Sacramento, CA 95817-2307
Phone
(916) 734-5293
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A180647 CA
Pediatric Rehabilitation Medicine Physician 2081P0010X A180647 CA Primary

Addresses

Primary practice location

4860 Y St Ste 3850
Sacramento, CA 95817-2307

Mailing address

4860 Y St Ste 3850
Sacramento, CA 95817-2307

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
I20250924003827 CA Practitioner - Pediatric MedicinePractitioner - Physical Medicine and Rehabilitation 5991188872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10545 Armstrong Ave
Suite 1200
Mather, CA 95655-4101

PO Box 8500 Lockbox
Suite 7642
Philadelphia, PA 19178

PO Box 8500 Lockbox
Suite 7642
Philadelphia, PA 19178-7642

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A180647CAMDPediatric Rehabilitation Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children Pediatrics CurrentSince Dec 22, 2025 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 20, 2025 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 20, 2025 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Shriners Hospitals for Children CurrentSince Dec 22, 2025 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

4860 Y St
Ste 3850
Sacramento, CA 95817
Phone (916) 734-5292

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

2425 Stockton Blvd
Sacramento, CA 95817
Phone (916) 453-2000

4860 Y St
Ste 1100
Sacramento, CA 95817
Phone (916) 734-6700

Interoperability endpoints

  • Direct secure messaging: mrasmussen589665@hisp.ehr.sutterhealth.org

Organizations & group practices 8

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1073074290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 3850",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 3850",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-5293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSSEN",
        "first_name": "MARY",
        "middle_name": "ANNELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A180647",
            "primary": false
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "CA",
            "license": "A180647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.