Individual provider Active NPI

Samuel James Saunders

  • Student in an Organized Health Care Education/Training Program
  • Plumas Lake, CA
National Provider Identifier
1154107332
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1299 Bamboo St
Plumas Lake, CA 95961-8714
Phone
(916) 910-8306
NPI assigned
Sep 5, 2023
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

1299 Bamboo St
Plumas Lake, CA 95961-8714

Mailing address

1299 Bamboo St
Plumas Lake, CA 95961-8714
Phone (916) 910-8306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20241118001390 ID Practitioner - Physician Assistant 0547794208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sterling Provider GroupGroup PAC ID 2264773373, 52 clinicians

Practice addresses (Care Compare)

1610 Caldwell Blvd
Nampa, ID 83651-1728
Phone (208) 207-8500

3185 E Ustick Rd
Meridian, ID 83646-5056
Phone (208) 296-7100

740 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone 20854291111026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Associates PLLC Current Accepting new patients
Sterling Provider Group CurrentSince Oct 23, 2024 Accepting new patients

Locations

10965 W Overland Rd
Boise, ID 83709
Phone (208) 900-9901

740 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 542-9111

3185 E Ustick Rd
Meridian, ID 83646
Phone (208) 296-7100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1154107332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 BAMBOO ST",
            "city": "PLUMAS LAKE",
            "state": "CA",
            "postal_code": "959618714",
            "telephone_number": "916-910-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 BAMBOO ST",
            "city": "PLUMAS LAKE",
            "state": "CA",
            "postal_code": "959618714",
            "telephone_number": "916-910-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "SAMUEL",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plumas Lake, CA

Sources for this page

Verify at the official NPI Registry.