Individual provider Active NPI

Jonathan Paul Man, MD

  • Clinical Cardiac Electrophysiology Physician
  • Sacramento, CA
National Provider Identifier
1255619789
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
C159950 Issued in CA
Practice address
2800 L St FL 6
Sacramento, CA 95816-5616
Phone
(916) 887-4040
Fax
(916) 887-4045
NPI assigned
Aug 2, 2011
Last updated
Jan 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT200414 PA
Clinical Cardiac Electrophysiology Physician 207RC0001X MT200414 PA
Clinical Cardiac Electrophysiology Physician 207RC0001X C159950 CA Primary

Addresses

Primary practice location

2800 L St FL 6
Sacramento, CA 95816-5616

Mailing address

10470 Old Placerville Rd Ste 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other identifiers 1

IdentifierTypeStateIssuer
871559MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140617000564 AZ Practitioner - Internal Medicine 6204050131 Reassigns benefits to 1 organization
I20190430000723 CA Practitioner - Cardiac ElectrophysiologyPractitioner - Internal Medicine 6204050131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

100 Mission Blvd
Jackson, CA 95642-2536

2 Medical Plaza Dr
Roseville, CA 95661-3042

200 Mission Blvd
Jackson, CA 95642-2564
Phone (916) 733-3777

2575 E Bidwell St
Suite 100
Folsom, CA 95630-6445
Phone (916) 817-3710

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

3161 L St
Sacramento, CA 95816-5234
Phone (916) 453-9999

3288 Bell Rd
Auburn, CA 95603-9243
Phone (530) 886-2300

3320 Bell Rd
Auburn, CA 95603-9243
Phone (530) 888-1266

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair70

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C159950CAMDClinical Cardiac Electrophysiology Physician
MT200414PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Sep 1, 2015 Accepting new patients
Yuma Regional Medical Center CurrentSince Sep 1, 2015 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jan 28, 2019 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jan 28, 2019 Accepting new patients
Sutter Gould Medical Foundation Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

2851 S Avenue B
Bldg 25
Yuma, AZ 85364
Phone (928) 336-7020

2851 S Avenue B
Ste 20
Yuma, AZ 85364

2575 E Bidwell St
Ste 260
Folsom, CA 95630
Phone (916) 817-3715

685 Twelve Bridges Dr
Ste B
Lincoln, CA 95648
Phone (916) 408-5915

2 Medical Plaza Dr
Ste 130
Roseville, CA 95661
Phone (916) 782-7778

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

2800 L St
Fl 6
Sacramento, CA 95816
Phone (916) 887-4040

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: jman428823@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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 3

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": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1255619789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 L ST FL 6",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165616",
            "telephone_number": "916-887-4040",
            "fax_number": "916-887-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAN",
        "first_name": "JONATHAN",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-02",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT200414",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "PA",
            "license": "MT200414",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "C159950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "871559",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.