Individual provider Active NPI

Denyse Nishio, M.D.

  • Internal Medicine Physician
  • Sacramento, CA
National Provider Identifier
1093790743
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G041955 Issued in CA
Practice address
2825 J St
Sacramento, CA 95816-4300
Phone
(916) 734-7777
Fax
(916) 734-8059
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G041955 CA Primary

Addresses

Primary practice location

2825 J St
Sacramento, CA 95816-4300

Mailing address

2825 J St Ste 300
Sacramento, CA 95816-4300
Phone (916) 734-7777

Other identifiers 1

IdentifierTypeStateIssuer
00G419550MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081209000228 CA Practitioner - Internal Medicine 0547321572 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G041955CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince May 20, 2008 Accepting new patients
Regents of the University of California CurrentSince May 20, 2008 Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

3111 Professional Dr
Auburn, CA 95603
Phone (530) 274-9762

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

2825 J St
Ste 300
Sacramento, CA 95816
Phone (916) 734-2890

3160 Folsom Blvd
Ste 1400
Sacramento, CA 95816
Phone (916) 731-1831

4900 Broadway
Ste 1200
Sacramento, CA 95820
Phone (916) 734-9255

3160 Folsom Blvd
Ste 2500
Sacramento, CA 95816
Phone (916) 734-5846

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

Organizations & group practices 3

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1093790743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 J ST STE 300",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164300",
            "telephone_number": "916-734-7777",
            "fax_number": "916-734-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164300",
            "telephone_number": "916-734-7777",
            "fax_number": "916-734-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIO",
        "first_name": "DENYSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G041955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G419550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.