Individual provider Active NPI

Sorabh Datta, MD

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1174151492
Registry record updated Dec 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
187357 Issued in CA
Practice address
45 E River Park PL W
Fresno, CA 93720-1562
Phone
(559) 603-7378
NPI assigned
Mar 31, 2020
Last updated
Dec 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 187357 CA Primary

Addresses

Primary practice location

45 E River Park PL W
Fresno, CA 93720-1562

Mailing address

45 E River Park PL W
Fresno, CA 93720-1562
Phone (559) 603-7378

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
I20231108002444 CA Practitioner - Internal Medicine 2769803105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health PartnersGroup PAC ID 6608280268, 497 clinicians

Practice addresses (Care Compare)

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.04 of 100Reported as group
Quality
78.62
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
187357CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partners CurrentSince Sep 1, 2023 Accepting new patients
Arkansas Health Group Internal Medicine PastSince Apr 1, 2020 Accepting new patients
Arkansas Health Group PastSince Apr 1, 2020 Accepting new patients

Locations

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

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.

Hospital & facility affiliations 2

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701475200000",
    "number": "1174151492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 E RIVER PARK PL W",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201562",
            "telephone_number": "559-603-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 E RIVER PARK PL W",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201562",
            "telephone_number": "559-603-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTA",
        "first_name": "SORABH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "187357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.