Individual provider Active NPI

Sandra Lucile Kemptner, PA-C

  • Medical Physician Assistant
  • Sacramento, CA
National Provider Identifier
1265710396
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA21660 Issued in CA
Practice address
87 Scripps Drive
Suite 310
Sacramento, CA 95825-6318
Phone
(916) 779-1160
Fax
(916) 779-1166
NPI assigned
Jul 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21660 CA
Medical Physician Assistant 363AM0700X PA21660 CA Primary

Addresses

Primary practice location

87 Scripps Drive
Suite 310
Sacramento, CA 95825-6318

Mailing address

87 Scripps Dr
Suite 310
Sacramento, CA 95825-6318
Phone (916) 779-1160

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000772 CA Practitioner - Physician Assistant 9537331335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Dermatology Associates, Inc.Group PAC ID 1052418175, 118 clinicians

Practice addresses (Care Compare)

2625 Fair Oaks Blvd
Suite 1
Sacramento, CA 95864-4936
Phone (916) 646-3376

355 Lennon LN
Suite 255
Walnut Creek, CA 94598-2496
Phone (925) 932-7704

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
21660CAMDSpeech-Language Pathologist
PA21660CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Feb 1, 2023 Accepting new patients

Locations

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

2625 Fair Oaks Blvd
Ste 1
Sacramento, CA 95864
Phone (916) 646-3376

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1265710396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 SCRIPPS DR",
            "address_2": "SUITE 310",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256318",
            "telephone_number": "916-779-1160",
            "fax_number": "916-779-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 SCRIPPS DRIVE",
            "address_2": "SUITE 310",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256318",
            "telephone_number": "916-779-1160",
            "fax_number": "916-779-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMPTNER",
        "first_name": "SANDRA",
        "middle_name": "LUCILE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-22",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21660",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.