NPIMap

Organization Active NPI

Regents of the University of Ca

  • Clinic/Center
  • Sacramento, CA
National Provider Identifier
1124008719
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
REGENTS OF THE UNIVERSITY OF CA
Practice address
2000 O St
Ste 210
Sacramento, CA 95811-5224
Phone
(916) 442-1011
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Allen D Hall
Title
Medical Director
Phone
(916) 734-8203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2000 O St
Ste 210
Sacramento, CA 95811-5224

Mailing address

10850 White Rock Rd
Rancho Cordova, CA 95670-6044
Phone (916) 734-9654

Other identifiers 1

IdentifierTypeStateIssuer
GR006392AMedicaidCA

Other names 1

  • Regents UCDMG Capitol Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118001149 CA Part B Supplier - Clinic/Group Practice 8022922475 Receives reassigned benefits from 924 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA; Stockton, CA; Walnut Creek, CA; Roseville, CA; Auburn, CA; Chico, CA; Citrus Heights, CA; Davis, CA…

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory

Locations

2660 W Covell Blvd
Davis, CA 95616
Phone (530) 747-3000

3301 C St
Ste 1800
Sacramento, CA 95816

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1124008719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 WHITE ROCK RD",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706044",
            "telephone_number": "916-734-9654",
            "fax_number": "916-736-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 O ST",
            "address_2": "STE 210",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115224",
            "telephone_number": "916-442-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "916-734-8203"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR006392A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regents UCDMG Capitol",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Regents UCDMG Capitol",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.