NPIMap

Individual provider Active NPI

Saman Hayatdavoudi, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Sacramento, CA
National Provider Identifier
1093912958
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A116819 Issued in CA
Practice address
1508 Alhambra Blvd Ste 200
Sacramento, CA 95816-6510
Phone
(916) 325-1040
Fax
(916) 669-4100
NPI assigned
Jul 2, 2007
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A116819 CA
Pulmonary Disease Physician 207RP1001X A116819 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A116819 CA Primary

Addresses

Primary practice location

1508 Alhambra Blvd Ste 200
Sacramento, CA 95816-6510

Mailing address

1300 Ethan Way Ste 600
Sacramento, CA 95825-2296
Phone (916) 679-3590

Other identifiers 1

IdentifierTypeStateIssuer
A116819OtherCACA MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130328000050 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 4486792223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pulmonary Medicine Associates Medical Group Inc.Group PAC ID 4981506730, 93 clinicians

Practice addresses (Care Compare)

5 Medical Plaza Dr
Suite 190
Roseville, CA 95661-2867
Phone (916) 679-3590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
94.18
Promoting interoperability
100
Improvement activities
40
Cost
75.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
116819CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Medicine Associates Sleep Lab Inc. Pulmonary Disease CurrentSince Jun 15, 2013 Accepting new patients
Pulmonary Medicine Associates Medical Group, Inc Critical Care Medicine CurrentSince Jun 15, 2013 Accepting new patients
Stephen Holtzclaw MD PC Reno Critical Care Medicine Past Accepting new patients
Sutter Regional Medical Foundation Internal Medicine Past Accepting new patients
Sierra Hospitalists LLC Internal Medicine Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

6403 Coyle Ave
Ste 450
Carmichael, CA 95608
Phone (916) 482-7621

5 Medical Plaza Dr
Ste 190
Roseville, CA 95661
Phone (916) 679-3590

1300 Ethan Way
Ste 600
Sacramento, CA 95825
Phone (916) 482-7623

1485 River Park Dr
Ste 200
Sacramento, CA 95815
Phone (916) 325-1040

1508 Alhambra Blvd
Ste 200
Sacramento, CA 95816
Phone (916) 325-1040

Interoperability endpoints

  • Direct secure messaging: saman.hayatdavoudi.1@1119.direct.athenahealth.com
  • Direct secure messaging: shayatdavoudi1657782@oc.providencedirect.org
  • Direct secure messaging: shayatdavoudi171919@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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 8

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1093912958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 ETHAN WAY STE 600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252296",
            "telephone_number": "916-679-3590",
            "fax_number": "916-482-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 ALHAMBRA BLVD STE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958166510",
            "telephone_number": "916-325-1040",
            "fax_number": "916-669-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYATDAVOUDI",
        "first_name": "SAMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A116819",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A116819",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A116819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "A116819",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.