Individual provider Active NPI

Angelo Joco Nazareno, M.D.

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1104886753
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A45071 Issued in CA
Practice address
8118 Timberlake Way
Suite 230
Sacramento, CA 95823-5400
Phone
(916) 688-5040
Fax
(916) 688-7866
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A45071 CA Primary

Addresses

Primary practice location

8118 Timberlake Way
Suite 230
Sacramento, CA 95823-5400

Mailing address

8118 Timberlake Way
Suite 230
Sacramento, CA 95823-5400
Phone (916) 688-5040

Other identifiers 1

IdentifierTypeStateIssuer
00A45071MedicaidCA

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
I20120315000314 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1052570785

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45071CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Physicians Care Solutions, Inc. Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: anazareno40631@hisp.ehr.sutterhealth.org

Organizations & group practices 2

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1104886753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8118 TIMBERLAKE WAY",
            "address_2": "SUITE 230",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235400",
            "telephone_number": "916-688-5040",
            "fax_number": "916-688-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8118 TIMBERLAKE WAY",
            "address_2": "SUITE 230",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235400",
            "telephone_number": "916-688-5040",
            "fax_number": "916-688-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARENO",
        "first_name": "ANGELO",
        "middle_name": "JOCO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A45071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A45071",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.