Individual provider Active NPI

Joshua Reza Khoshsefat, NP

  • Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1083169908
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95004753 Issued in CA
Practice address
555 Capitol Mall Ste 570
Sacramento, CA 95814-4502
Phone
(916) 441-0400
NPI assigned
Aug 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95004753 CA Primary

Addresses

Primary practice location

555 Capitol Mall Ste 570
Sacramento, CA 95814-4502

Mailing address

555 Capitol Mall Ste 570
Sacramento, CA 95814-4502
Phone (916) 441-0400

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161006002528 CA Practitioner - Nurse Practitioner 5092003020 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgery Medical Group IncGroup PAC ID 7214006816, 205 clinicians

Practice addresses (Care Compare)

4001 J St
Sacramento, CA 95819-3626
Phone (916) 453-4545

6501 Coyle Ave
Carmichael, CA 95608-0306
Phone (916) 537-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95004753CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Feb 3, 2018 Accepting new patients
Physician Assistant Surgical Assist, Inc CurrentSince May 13, 2017 Accepting new patients
Permanente Medical Group Inc CurrentSince Feb 3, 2018 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Acute Care Surgery Medical Group, Inc. CurrentSince Oct 1, 2016 Accepting new patients
Acute Care Surgery Medical Group, Inc. PastSince Jul 2, 2023 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

6555 Coyle Ave
Ste 220
Carmichael, CA 95608
Phone (916) 241-9677

1651 Creekside Dr
Ste 100
Folsom, CA 95630
Phone (702) 458-2304

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

807 Illinois Ave
Los Banos, CA 93635
Phone (209) 710-8542

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (949) 364-7744

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

6520 Lonetree Blvd
Ste 2009
Rocklin, CA 95765
Phone (702) 458-2304

6600 Bruceville Rd
Sacramento, CA 95823

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

1800 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 252-2225

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 7

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": "1471737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1083169908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 CAPITOL MALL STE 570",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958144502",
            "telephone_number": "916-441-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CAPITOL MALL STE 570",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958144502",
            "telephone_number": "916-441-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSHSEFAT",
        "first_name": "JOSHUA",
        "middle_name": "REZA",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-21",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95004753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6600 Bruceville Rd",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958234671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.