Jacob R Lipovac, MEDICAL STUDENT

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

4301 X St
Sacramento, CA 95817-2214

Phone

(916) 734-2011

NPI assigned

Jun 7, 2023

Sex

Unspecified or another gender identity

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 26, 2024.

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1093409476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8804 SAWTELLE WAY APT B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262114",
            "telephone_number": "636-399-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172214",
            "telephone_number": "916-734-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPOVAC",
        "first_name": "JACOB",
        "middle_name": "R",
        "credential": "MEDICAL STUDENT",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2023-06-07",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine A Liou, DO
• Frank Kevin Liou, MD
• Bethany Marie Lipa, MD
• Carl Lipanovich
• Steven Lipiec
• Tracy Lynne Lippert
• Randall Brian Lippins
• Mark H. Lipson, MD
• Scott R. Lipson, M.D.
• Lisa B Lipton, PA

• All providers in Sacramento, CA
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.