Individual provider Active NPI

Frederick Root Sautter Jr., LCSW

  • Clinical Social Worker
  • Roseville, CA
National Provider Identifier
1083044960
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW72308 Issued in CA
Practice address
1430 Blue Oaks Blvd Ste 120
Roseville, CA 95747-5156
Phone
(707) 481-7744
Fax
(877) 349-6094
NPI assigned
Nov 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9006-C NV
Clinical Social Worker 1041C0700X 7896-C AR
Clinical Social Worker 1041C0700X LCSW72308 CA Primary

Addresses

Primary practice location

1430 Blue Oaks Blvd Ste 120
Roseville, CA 95747-5156

Mailing address

1070 Kirkland LN
Lincoln, CA 95648-7209
Phone (707) 481-7744

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL rick@evolutionsintherapy.com Health Information Exchange (HIE)

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191108001417 CA Practitioner - Clinical Social Worker 4486086683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1430 Blue Oaks Blvd
Suite 120
Roseville, CA 95747-5156
Phone (916) 755-6141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7896-CARMDClinical Social Worker
LCSW72308CAMDClinical Social Worker
9006-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick R Sautter Licensed Clinical Social Worker Inc Clinical CurrentSince Aug 13, 2019 Accepting new patients

Locations

915 Highland Pointe Dr
Ste 250
Roseville, CA 95678
Phone (530) 713-4306

1430 Blue Oaks Blvd
Ste 120
Roseville, CA 95747
Phone (916) 579-3802

Organizations & group practices 1

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": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1083044960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 KIRKLAND LN",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956487209",
            "telephone_number": "707-481-7744",
            "fax_number": "877-349-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 BLUE OAKS BLVD STE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957475156",
            "telephone_number": "707-481-7744",
            "fax_number": "877-349-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUTTER",
        "first_name": "FREDERICK",
        "middle_name": "ROOT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-14",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9006-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "7896-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW72308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rick@evolutionsintherapy.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "915 Highland Pointe Dr Ste 250",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956785421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.