Active NPI
Samantha Rundle
- Student in an Organized Health Care Education/Training Program
- Sacramento, CA
National Provider Identifier
1073353108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 20A24559
- Practice address
- 1201 Alhambra Blvd Ste 300
Sacramento, CA 95816-5241 - Phone
- (916) 731-7866
- NPI assigned
- May 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 20A24559 | CA | Primary |
Addresses
Primary practice location
1201 Alhambra Blvd Ste 300
Sacramento, CA 95816-5241
Mailing address
1201 Alhambra Blvd Ste 300
Sacramento, CA 95816-5241
Phone (916) 731-7866
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241212003831 | CA | Order and Referring Only - Family Practice | 9436685443 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A24559 | CA | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- srundle652861@hisp.ehr.sutterhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772409600000",
"number": "1073353108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 ALHAMBRA BLVD STE 300",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165241",
"telephone_number": "916-731-7866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 ALHAMBRA BLVD STE 300",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165241",
"telephone_number": "916-731-7866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNDLE",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-28",
"last_updated": "2026-03-02",
"certification_date": "2026-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "20A24559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.