Individual provider Active NPI

Abasi Bomani, MD

  • Urgent Care Clinic/Center
  • Stockton, CA
National Provider Identifier
1104388180
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
A180702 Issued in CA
Practice address
2545 W Hammer LN
Stockton, CA 95209-2839
Phone
(213) 226-7443
NPI assigned
Apr 1, 2019
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X A180702 CA Primary
Family Medicine Physician 207Q00000X 180702 CA

Addresses

Primary practice location

2545 W Hammer LN
Stockton, CA 95209-2839

Mailing address

2545 W Hammer LN
Stockton, CA 95209-2839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221005001941 CA Practitioner - Family Practice 5092040527 Reassigns benefits to 3 organizations
I20230905001090 TX Practitioner - Family Practice 5092040527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
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)

2505 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2545 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2800 L St
Sacramento, CA 95816-5616

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

815 Court St
Jackson, CA 95642-2154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
180702CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation Current Accepting new patients
St. Johns Community Health CurrentSince Sep 16, 2022 Accepting new patients
St. Johns Community Health Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Signify Health Medical Associates of California, PC CurrentSince Jan 31, 2024 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
St. Johns Community Health CurrentSince Sep 16, 2022 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Sutter Valley Medical Foundation Family Medicine Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 1, 2024 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Aug 22, 2023 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Aug 22, 2023 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 1, 2024 Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

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

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

2545 W Hammer Ln
Stockton, CA 95209
Phone (209) 948-1641

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: abasibomani@sffp.allscriptsdirect.net
  • Direct secure messaging: abomani678556@hisp.ehr.sutterhealth.org

Organizations & group practices 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1104388180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092839",
            "telephone_number": "213-226-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMANI",
        "first_name": "ABASI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "A180702",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "180702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.