Individual provider Active NPI

Powell O. Jose, M.D.

  • Cardiovascular Disease Physician
  • Sacramento, CA
National Provider Identifier
1114107935
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A101413 Issued in CA
Practice address
5301 F Street
#117
Sacramento, CA 95819
Phone
(916) 733-1788
Fax
(916) 733-1787
NPI assigned
Nov 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A101413 CA
Internal Medicine Physician 207R00000X 036122651 IL
Cardiovascular Disease Physician 207RC0000X A101413 CA Primary

Addresses

Primary practice location

5301 F Street
#117
Sacramento, CA 95819

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

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
I20090202000084 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2961566245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Yale University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

200 Mission Blvd
Jackson, CA 95642-2564
Phone (916) 733-3777

2030 Sutter PL
Suite 1000
Davis, CA 95616-6215
Phone (530) 750-5800

2575 E Bidwell St
Suite 100
Folsom, CA 95630-6445
Phone (916) 817-3710

2700 Low CT
Fairfield, CA 94534-9715
Phone (707) 432-2500

2702 Low CT
Fairfield, CA 94534-9771
Phone (707) 432-2600

2720 Low CT
Fairfield, CA 94534-9771
Phone (707) 428-2731

2800 L St
Sacramento, CA 95816-5616

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

3161 L St
Sacramento, CA 95816-5234
Phone (916) 453-9999

3288 Bell Rd
Auburn, CA 95603-9243
Phone (530) 886-2300

3320 Bell Rd
Auburn, CA 95603-9243
Phone (530) 888-1266

5765 Greenback LN
Sacramento, CA 95841-2013
Phone (916) 865-1040

635 Anderson Rd
Suite 10
Davis, CA 95616-3505
Phone (530) 758-1122

815 Court St
Jackson, CA 95642-2154

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101413CAMDDentist
A101413CAMDInternal Medicine Physician
036122651ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Internal Medicine Current Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: pjose27072@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 5

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": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1114107935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 F STREET",
            "address_2": "#117",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95819",
            "telephone_number": "916-733-1788",
            "fax_number": "916-733-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSE",
        "first_name": "POWELL",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A101413",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036122651",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A101413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.