Individual provider Active NPI

John T Hata, M.D.

  • Gastroenterology Physician
  • Sacramento, CA
National Provider Identifier
1205800042
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
00G279460 Issued in CA
Practice address
8120 Timberlake Way
Ste 101
Sacramento, CA 95823-5412
Phone
(916) 423-2124
Fax
(916) 423-2127
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 00G279460 CA Primary

Addresses

Primary practice location

8120 Timberlake Way
Ste 101
Sacramento, CA 95823-5412

Mailing address

8120 Timberlake Way
Ste 101
Sacramento, CA 95823-5412
Phone (916) 423-2124

Other identifiers 2

IdentifierTypeStateIssuer
100002785OtherCARAILROAD MEDICARE
00G279460MedicaidCA

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27946CAMDClinical Social Worker
00G279460CAMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1205800042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 TIMBERLAKE WAY",
            "address_2": "STE 101",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235412",
            "telephone_number": "916-423-2124",
            "fax_number": "916-423-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 TIMBERLAKE WAY",
            "address_2": "STE 101",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235412",
            "telephone_number": "916-423-2124",
            "fax_number": "916-423-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATA",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "00G279460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100002785",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G279460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.