Individual provider Active NPI

Susan Sum, NP

  • Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1104644111
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95032342 Issued in CA
Practice address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(530) 209-1316
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95032342 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd
Sacramento, CA 95817-2201

Mailing address

3230 Arena Blvd
Ste 245 PMB 153
Sacramento, CA 95834-3004
Phone (530) 209-1316

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241231001244 CA Practitioner - Nurse Practitioner 7012444144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone (916) 734-2680

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

4868 X St
Sacramento, CA 95817-2205

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95032342CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Jan 1, 2025 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Jan 1, 2025 Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

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

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

4860 Y St
Ste 2100
Sacramento, CA 95817
Phone (916) 734-3800

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.

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": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1104644111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 ARENA BLVD",
            "address_2": "STE 245 PMB 153",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958343004",
            "telephone_number": "530-209-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "530-209-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUM",
        "first_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95032342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.