Individual provider Active NPI

Samand Sebghati, O.D.

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1124455639
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4811 Issued in FL
Practice address
1600 Expo Parkway
Sacramento, CA 95815
Phone
(916) 922-2100
NPI assigned
Sep 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4811 FL Primary

Addresses

Primary practice location

1600 Expo Parkway
Sacramento, CA 95815

Mailing address

1600 Expo Parkway
Sacramento, CA 95815
Phone (513) 417-7004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250626001343 WA Practitioner - Optometry 5496267106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Provider Enterprise LLCGroup PAC ID 0840458667, 8 clinicians

Practice addresses (Care Compare)

135 S 336TH St
Federal Way, WA 98003-6350
Phone (253) 835-7433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4811FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Provider Enterprise LLC Optometrist CurrentSince Jun 1, 2025 Accepting new patients

Locations

8500 W 110th St
Ste 260
Overland Park, KS 66210
Phone (941) 224-3674

2235 Lake Heights Dr
Everett, WA 98208
Phone (425) 332-4455

135 S 336th St
Federal Way, WA 98003
Phone (253) 835-7433

Organizations & group practices 1

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": "1380326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1124455639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 EXPO PARKWAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95815",
            "telephone_number": "513-417-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 EXPO PARKWAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95815",
            "telephone_number": "916-922-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBGHATI",
        "first_name": "SAMAND",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-28",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.