Individual provider Active NPI

Tal Vitaly Sraboyants, N.P.

  • Nurse Practitioner
  • Yuba City, CA
National Provider Identifier
1144623653
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95000745 Issued in CA
Practice address
440 Plumas Blvd
Yuba City, CA 95991-5071
Phone
(530) 749-3346
NPI assigned
Sep 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95000745 CA Primary

Addresses

Primary practice location

440 Plumas Blvd
Yuba City, CA 95991-5071

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (855) 771-0335

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150126001804 CA Practitioner - Nurse Practitioner 7810211638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
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)

16911 Willow Glen Rd
Brownsville, CA 95919-9707
Phone (530) 675-2457

2800 L St
Sacramento, CA 95816-5616

440 Plumas Blvd
Yuba City, CA 95991-5071
Phone (530) 749-3409

444 Plumas Blvd
Yuba City, CA 95991-5071
Phone (530) 749-3420

726 4TH St
Marysville, CA 95901-5656
Phone (530) 749-4300

Hospital & facility affiliations

  • Adventist Health and Rideout Hospital, Marysville, CA, CCN 050133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95000745CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Nurse Practitioner CurrentSince Jan 1, 2015 Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

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

1201 Alhambra Blvd
Ste 10
Sacramento, CA 95816
Phone (916) 731-7868

Interoperability endpoints

  • Direct secure messaging: tsraboyants187449@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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 1

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": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1144623653",
    "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": "855-771-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 PLUMAS BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959915071",
            "telephone_number": "530-749-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRABOYANTS",
        "first_name": "TAL VITALY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-29",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95000745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.