Individual provider Active NPI

Terry E. Raposa, DO

  • Family Medicine Physician
  • Folsom, CA
National Provider Identifier
1174601744
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6992 Issued in CA
Practice address
82 Clarksville Rd Ste 120
Folsom, CA 95630-8210
Phone
(916) 983-8868
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A6992 CA Primary

Addresses

Primary practice location

82 Clarksville Rd Ste 120
Folsom, CA 95630-8210

Mailing address

82 Clarksville Rd Ste 120
Folsom, CA 95630-8210
Phone (916) 983-8868

Other practice location 1

11634 Fair Oaks Blvd
Fair Oaks, CA 95628-3771
Phone (916) 983-8868

Other identifiers 1

IdentifierTypeStateIssuer
00AX69920MedicaidCA

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
I20101208001314 CA Practitioner - Family Practice 6002943958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Living Primary Care IncGroup PAC ID 7618062225, 20 clinicians

Practice addresses (Care Compare)

11634 Fair Oaks Blvd
Fair Oaks, CA 95628-3771
Phone (916) 983-8868

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6992CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Living Primary Care, Inc Family Medicine CurrentSince May 1, 2023 Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

11634 Fair Oaks Blvd
Fair Oaks, CA 95628
Phone (916) 852-6001

82 Clarksville Rd
Ste 120
Folsom, CA 95630
Phone (916) 299-9859

2545 E Bidwell St
Ste 110
Folsom, CA 95630
Phone (916) 941-7362

Interoperability endpoints

  • Direct secure messaging: traposa168236@hpmg.direct-ci.net

Organizations & group practices 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1174601744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 CLARKSVILLE RD STE 120",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308210",
            "telephone_number": "916-983-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 CLARKSVILLE RD STE 120",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308210",
            "telephone_number": "916-983-8868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11634 Fair Oaks Blvd",
            "address_purpose": "LOCATION",
            "city": "Fair Oaks",
            "state": "CA",
            "postal_code": "956283771",
            "country_code": "US",
            "telephone_number": "916-983-8868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAPOSA",
        "first_name": "TERRY",
        "middle_name": "E.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX69920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.