Individual provider Active NPI

Saber Jameel Patrus, MD

  • Internal Medicine Physician
  • Mission Hills, CA
National Provider Identifier
1255587580
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A101366 Issued in CA
Practice address
11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone
(818) 837-5789
Fax
(818) 898-9282
NPI assigned
Aug 18, 2008
Last updated
Apr 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A101366 CA Primary
Hospitalist Physician 208M00000X A101366 CA

Addresses

Primary practice location

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5691

Other identifiers 1

IdentifierTypeStateIssuer
00A1013660MedicaidCA

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
I20081107000601 CA Practitioner - Internal Medicine 0941369714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531

19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101366CAMDPediatric Dentist
A101366CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation Internal Medicine CurrentSince Aug 18, 2008 Accepting new patients
Providence Facey Medical Foundation CurrentSince Aug 18, 2008 Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

11333 Sepulveda Blvd
Mission Hills, CA 91345
Phone (818) 365-9531

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: spatrus350531@oc.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1255587580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5691",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11333 SEPULVEDA BLVD",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451116",
            "telephone_number": "818-837-5789",
            "fax_number": "818-898-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRUS",
        "first_name": "SABER",
        "middle_name": "JAMEEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-18",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A101366",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A101366",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A1013660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

Verify at the official NPI Registry.