Individual provider Active NPI

Prasad Jogu, M.D.

  • Hospitalist Physician
  • Roseville, CA
National Provider Identifier
1104123165
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
C153206 Issued in CA
Practice address
1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone
(916) 781-1927
Fax
(916) 781-1787
NPI assigned
Feb 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 270736 NY
Hospitalist Physician 208M00000X 270736 NY
Hospitalist Physician 208M00000X C153206 CA Primary
Internal Medicine Physician 207R00000X C153295 CA

Addresses

Primary practice location

1 Medical Plaza Dr
Roseville, CA 95661-3037

Mailing address

10470 Old Placerville Rd Ste 100
Sacramento, CA 95827-2539
Phone (800) 972-5547

Other practice location 1

33-57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6622

Other identifiers 1

IdentifierTypeStateIssuer
03623058MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180131002291 CA Practitioner - Hospitalist 6608019914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

2 Medical Plaza Dr
Roseville, CA 95661-3042

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C153295CAMDInternal Medicine Physician
C153206CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Internal Medicine Current Accepting new patients
Sutter Valley Medical Foundation Internal Medicine CurrentSince Feb 12, 2018 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 12, 2018 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

2750 Gateway Oaks Dr
Ste 150
Sacramento, CA 95833
Phone (916) 887-7398

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

Interoperability endpoints

  • Direct secure messaging: pjogu388029@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1298678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104123165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-972-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PLAZA DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613037",
            "telephone_number": "916-781-1927",
            "fax_number": "916-781-1787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33-57 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "NY",
            "postal_code": "137902107",
            "country_code": "US",
            "telephone_number": "607-763-6622",
            "fax_number": "607-763-5064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOGU",
        "first_name": "PRASAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "270736",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "270736",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "C153206",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C153295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03623058",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.