NPIMap

Individual provider Active NPI

Cameron Petro-Sakuma, D.O.

  • Internal Medicine Physician
  • Salina, KS
National Provider Identifier
1093248668
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
05-42889 Issued in KS
Practice address
2090 S Ohio St
Salina, KS 67401-6702
Phone
(785) 825-8221
Fax
(785) 452-7530
NPI assigned
Apr 10, 2017
Last updated
Jul 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 05-42889 KS
Internal Medicine Physician 207R00000X 05-42889 KS Primary

Addresses

Primary practice location

2090 S Ohio St
Salina, KS 67401-6702

Mailing address

2090 S Ohio St
Salina, KS 67401-6702
Phone (785) 825-8221

Other identifiers 1

IdentifierTypeStateIssuer
201284360AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200428000833 KS Practitioner - Internal MedicinePractitioner - Hospitalist 8325478647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Salina Regional Health Center IncGroup PAC ID 0446168215, 160 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2090 S Ohio St
Salina, KS 67401-6702

2600 Compass Rd
Glenview, IL 60026-8001

400 S Santa Fe Ave
Salina, KS 67401-4144

520 S Santa Fe Ave
Salina, KS 67401-4190

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.42 of 100Reported as group
Quality
79.94
Promoting interoperability
100
Improvement activities
40
Cost
71.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05-42889KSMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salina Regional Health Center Inc CurrentSince May 1, 2020 Accepting new patients
Salina Regional Health Center, Inc. Internal Medicine CurrentSince May 1, 2020 Accepting new patients
Salina Regional Health Center, Inc Hospitalist Current Accepting new patients
HMG Park Manor of Salina, LLC Past Accepting new patients
Recover-Care Pinnacle Park LLC Past Accepting new patients
Holiday Resort of Salina Operations, LLC Past Accepting new patients

Locations

2090 S Ohio St
Salina, KS 67401
Phone (785) 309-2323

2265 S 9th St
Salina, KS 67401
Phone (785) 452-6000

400 S Santa Fe Ave
Salina, KS 67401
Phone (785) 452-6019

Interoperability endpoints

  • Direct secure messaging: cameron.petro-sakuma@srhcdirect.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
HMG ServicesSalina, KS, CCN 175185 Skilled nursing facility Adp of the SNF Dec 31, 2023
Pinnacle Park Nursing & RehabilitationSalina, KS, CCN 175184 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 28, 2025
Feb 11, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1093248668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 S OHIO ST",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674016702",
            "telephone_number": "785-825-8221",
            "fax_number": "785-452-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 S OHIO ST",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674016702",
            "telephone_number": "785-825-8221",
            "fax_number": "785-452-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRO-SAKUMA",
        "first_name": "CAMERON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KS",
            "license": "05-42889",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "05-42889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201284360A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

Verify at the official NPI Registry.