Individual provider Active NPI

Sagarika Basu, PA

  • Physician Assistant
  • Rancho Cucamonga, CA
National Provider Identifier
1174295687
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
63153 Issued in CA
Practice address
9481 Pittsburgh Ave Ste 200
Rancho Cucamonga, CA 91730-9021
Phone
(909) 655-0300
NPI assigned
Oct 3, 2021
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 63153 CA Primary

Addresses

Primary practice location

9481 Pittsburgh Ave Ste 200
Rancho Cucamonga, CA 91730-9021

Mailing address

9481 Pittsburgh Ave Ste 200
Rancho Cucamonga, CA 91730-9021
Phone (909) 655-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63153CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Digestive Health Current Accepting new patients
Florida Diabetes Thyroid & Endocrine Center PL Endocrinology, Diabetes & Metabolism PastSince Jun 30, 2024 Accepting new patients

Locations

9481 Pittsburgh Ave
Ste 200
Rch Cucamonga, CA 91730
Phone (909) 303-2260

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECIGDD

Organizations & group practices 2

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": "1633219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1174295687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9481 PITTSBURGH AVE STE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309021",
            "telephone_number": "909-655-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9481 PITTSBURGH AVE STE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309021",
            "telephone_number": "909-655-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASU",
        "first_name": "SAGARIKA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-03",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.