Active NPI
Godwin Sammut, DC
- Chiropractor
- Pleasanton, CA
National Provider Identifier
1114149598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC24793
- Practice address
- 4125 Mohr Ave., Suite K
Pleasanton, CA 94566 - Phone
- (925) 484-3955
- Fax
- (925) 484-3045
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC24793 | CA | Primary |
Addresses
Primary practice location
4125 Mohr Ave., Suite K
Pleasanton, CA 94566
Mailing address
4125 Mohr Ave., Suite K
Pleasanton, CA 94566
Phone (925) 484-3955
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC024793 | Other | CA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090701000612 | CA | Practitioner - Chiropractic | 6103977129 | Practice locations: Pleasanton, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College - West, 1996
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4125 Mohr Ave
Pleasanton, CA 94566-4749
Phone (925) 484-1070
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC24793 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114149598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4125 MOHR AVE., SUITE K",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "94566",
"telephone_number": "925-484-3955",
"fax_number": "925-484-3045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4125 MOHR AVE., SUITE K",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "94566",
"telephone_number": "925-484-3955",
"fax_number": "925-484-3045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMMUT",
"first_name": "GODWIN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC24793",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "DC024793",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.