Active NPI
Paulino D Sambat Jr., MD
- General Practice Physician
- Fredericksburg, VA
National Provider Identifier
1073509170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 0101021882
- Practice address
- 106 Falcon Dr
Fredericksburg, VA 22408-1931 - Phone
- (540) 898-8400
- Fax
- (540) 898-6642
- NPI assigned
- Sep 23, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 0101021882 | VA | |
| General Practice Physician | 208D00000X | 0101021882 | VA | Primary |
Addresses
Primary practice location
106 Falcon Dr
Fredericksburg, VA 22408-1931
Mailing address
106 Falcon Dr
Fredericksburg, VA 22408-1931
Phone (540) 898-8400
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1034031 | Other | FIRST HEALTH | |
| 4385900 | Other | AETNA | |
| 540992335-01 | Other | SOUTHERN HEALTH | |
| 0478594 | Other | HMO | |
| 2551020 | Other | CIGNA | |
| 010201 | Other | BS | |
| 10785 | Other | SENTARA | |
| 17 00515 | Other | UNITED HEALTHCARE | |
| 213149 | Other | MDIPA | |
| 7341440 | Medicaid | VA | |
| 540992335 | Other | TRICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101021882 | VA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351468800000",
"number": "1073509170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 FALCON DR",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224081931",
"telephone_number": "540-898-8400",
"fax_number": "540-898-6642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 FALCON DR",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224081931",
"telephone_number": "540-898-8400",
"fax_number": "540-898-6642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMBAT",
"first_name": "PAULINO",
"middle_name": "D",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-23",
"last_updated": "2012-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "VA",
"license": "0101021882",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0101021882",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "1034031",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4385900",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH",
"identifier": "540992335-01",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO",
"identifier": "0478594",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2551020",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS",
"identifier": "010201",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "10785",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "17 00515",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA",
"identifier": "213149",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7341440",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "540992335",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.