Individual provider Active NPI

Randall L Stenson, MD

  • Addiction Psychiatry Physician
  • Sacramento, CA
National Provider Identifier
1164465357
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
G25548 Issued in CA
Practice address
2100 Capitol Ave
Ste a
Sacramento, CA 95816-5721
Phone
(916) 442-4985
Fax
(916) 442-7154
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X G25548 CA
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X DEAX58196190 CA
Addiction Psychiatry Physician 2084P0802X G25548 CA Primary

Addresses

Primary practice location

2100 Capitol Ave
Ste a
Sacramento, CA 95816-5721

Mailing address

2100 Capitol Ave
Sacramento, CA 95816-5721
Phone (916) 442-4985

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051230000479 CA Practitioner - PsychiatryPractitioner - Addiction Medicine 7214959444 Reassigns benefits to 1 organization
Practice locations: Sacramento, CA

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
University of California, Davis School of Medicine, 1972
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2100 Capitol Ave
Sacramento, CA 95816-5721
Phone (916) 275-1081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DEAX58196190CAMDAddiction Medicine (Psychiatry & Neurology) Physician
G25548CAMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Touro University Medical Group Past Accepting new patients
Inland Psychiatric Offices Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e0d732aa-1d5c-42bf-b672-8fabe3feb437/

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1164465357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CAPITOL AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165721",
            "telephone_number": "916-442-4985",
            "fax_number": "916-442-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CAPITOL AVE",
            "address_2": "STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165721",
            "telephone_number": "916-442-4985",
            "fax_number": "916-442-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENSON",
        "first_name": "RANDALL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "G25548",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "DEAX58196190",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CA",
            "license": "G25548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.