Active NPI
Sarah Spivack
- Student in an Organized Health Care Education/Training Program
- Sacramento, CA
National Provider Identifier
1083347454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 4610 X St
Sacramento, CA 95817-2200 - Phone
- (916) 220-8101
- NPI assigned
- Jul 5, 2022
- 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 | Primary |
Addresses
Primary practice location
4610 X St
Sacramento, CA 95817-2200
Mailing address
4610 X St
Sacramento, CA 95817-2200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390200000X | Other | 39 STUDENT, HEALTH CARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 9168165931 | Direct |
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 |
|---|---|---|---|---|
| I20240905003818 | CA | Order and Referring Only - Family Practice | 4183164064 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656979200000",
"number": "1083347454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4610 X ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4610 X ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172200",
"telephone_number": "916-220-8101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPIVACK",
"first_name": "SARAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-05",
"last_updated": "2022-07-05",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "39 STUDENT, HEALTH CARE",
"identifier": "390200000X",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "9168165931",
"affiliation": "N",
"endpointDescription": "Personal Pager",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Pager number",
"address_1": "4610 X St",
"city": "Sacramento",
"state": "CA",
"country_code": "US",
"postal_code": "958172200",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jul 5, 2022; 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.