Individual provider Active NPI

Saeed Gholami, MD

  • Anesthesiology Physician
  • Manteca, CA
National Provider Identifier
1245348341
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G74551 Issued in CA
Practice address
1205 E North St
Manteca, CA 95336-4932
Phone
(209) 823-3111
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G74551 CA Primary

Addresses

Primary practice location

1205 E North St
Manteca, CA 95336-4932

Mailing address

10693 Wiles Rd PMB 137
Coral Springs, FL 33076-2014
Phone (954) 255-5200

Other identifiers 2

IdentifierTypeStateIssuer
00G745512MedicaidCA
00G745510OtherCABLUE CROSS

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
I20090209000183 CA Practitioner - Anesthesiology 5799840732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Cincinnati College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of California PCGroup PAC ID 5092897025, 44 clinicians

Practice addresses (Care Compare)

825 Delbon Ave
Turlock, CA 95382-2016
Phone (404) 941-1210

Hospital & facility affiliations

  • San Ramon Regional Medical Center Hospital, San Ramon, CA, CCN 050689

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G74551CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of California, PC Anesthesiology CurrentSince Aug 26, 2022 Accepting new patients
Executive Gi Services Anesthesiology Past Accepting new patients

Locations

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245348341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10693 WILES RD PMB 137",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330762014",
            "telephone_number": "954-255-5200",
            "fax_number": "954-255-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E NORTH ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364932",
            "telephone_number": "209-823-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOLAMI",
        "first_name": "SAEED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G74551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G745512",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00G745510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.