Individual provider Active NPI

Thomas P Prindiville, M.D.

  • Gastroenterology Physician
  • Sacramento, CA
National Provider Identifier
1104879923
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C40251 Issued in CA
Practice address
4150 V Street, Ste 3500
Sacramento, CA 95817-1460
Phone
(916) 734-7224
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X C40251 CA Primary

Addresses

Primary practice location

4150 V Street, Ste 3500
Sacramento, CA 95817-1460

Mailing address

4150 V St
Ste 3500
Sacramento, CA 95817-1460
Phone (916) 734-7224

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
I20081203000632 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 9133193733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Arkansas College of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

1004 Fowler Way
Suite 4
Placerville, CA 95667-5746
Phone (530) 626-9488

1095 Marshall Way
Placerville, CA 95667-5722

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy20
Upper gastrointestinal (GI) endoscopy for acid reflux34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40251CAMDPharmacist
C40251CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center CurrentSince Aug 1, 2014 Accepting new patients
Marshall Medical Center CurrentSince Aug 1, 2014 Accepting new patients
Sutter Regional Medical Foundation PastSince Aug 1, 2014 Accepting new patients

Locations

3501 Palmer Dr
Ste 204
Cameron Park, CA 95682
Phone (530) 626-9488

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

1000 Fowler Way
Ste 7
Placerville, CA 95667
Phone (530) 295-0608

1004 Fowler Way
Ste 4
Placerville, CA 95667
Phone (530) 626-9488

1095 Marshall Way
Ste 201
Placerville, CA 95667
Phone (530) 344-5470

Interoperability endpoints

  • Direct secure messaging: tprindiville94226@hpmg.direct-ci.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1104879923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "STE 3500",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-7224",
            "fax_number": "916-734-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V STREET, STE 3500",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINDIVILLE",
        "first_name": "THOMAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C40251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.