Organization Active NPI

Truemed Sacramento Inc

  • Home Health Agency
  • Fair Oaks, CA
National Provider Identifier
1245695105
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
TRUEMED SACRAMENTO INC
Practice address
5330 Primrose Dr Ste 133
Fair Oaks, CA 95628-3541
Phone
(916) 379-7790
NPI assigned
Dec 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Authorized official

Name
Peter Kozakov
Title
Principal Director
Phone
(650) 588-8331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

5330 Primrose Dr Ste 133
Fair Oaks, CA 95628-3541

Mailing address

400 Oyster Point Blvd Ste 201
South San Francisco, CA 94080-1918

Other names 1

  • TRUEMED SACRAMENTO Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180510000593 CA Part A Provider - Home Health Agency 1850655275 Practice locations: Fair Oaks, CA

Home health agency certification: CCN 559060

Legal name
TRUEMED SACRAMENTO INC
Doing business as
TRUEMED
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 9, 2019
Last certification
Oct 9, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 17, 2015 in CA
Enrollment address
5330 Primrose Dr
Ste 133
Fair Oaks, CA 95628-3541

Care Compare: Home health agency

Medicare Care Compare
Listed as
Truemed SacramentoCCN 559060
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Oct 9, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

5330 Primrose Dr
Ste 133
Fair Oaks, CA 95628
Phone (916) 379-7790

7529 Sunset Ave
Ste C5
Fair Oaks, CA 95628
Phone (916) 379-7790

400 Oyster Point Blvd
Ste 201
South San Francisco, CA 94080
Phone (650) 588-8331

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Iliya Radinsky Individual 5% Or Greater Direct Ownership Interest Nov 17, 2015 33.33%
Corporate Officer Nov 17, 2015
Peter Kozakov Individual 5% Or Greater Direct Ownership Interest Nov 17, 2015 33.34%
Corporate Officer Nov 17, 2015
W-2 Managing EmployeeCeo Nov 17, 2015
Simon Gleyzer Individual 5% Or Greater Direct Ownership Interest Nov 17, 2015 33.33%
Corporate Officer Nov 17, 2015

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1450483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1245695105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 OYSTER POINT BLVD STE 201",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940801918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 PRIMROSE DR STE 133",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283541",
            "telephone_number": "916-379-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUEMED SACRAMENTO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-19",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "KOZAKOV",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRINCIPAL DIRECTOR",
        "authorized_official_telephone_number": "650-588-8331"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRUEMED SACRAMENTO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TRUEMED SACRAMENTO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fair Oaks, CA

Sources for this page

Verify at the official NPI Registry.