Individual provider Active NPI

Monikankana Ayesha Alem, MD

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1275095259
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A179554 Issued in CA
Practice address
4860 Y St Ste 1600
Sacramento, CA 95817-2307
Phone
(916) 734-3630
Fax
(916) 734-5636
NPI assigned
Apr 1, 2019
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A179554 CA Primary

Addresses

Primary practice location

4860 Y St Ste 1600
Sacramento, CA 95817-2307

Mailing address

4860 Y St Ste 1600
Sacramento, CA 95817-2307
Phone (916) 734-3630

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
I20220912002042 CA Practitioner - Family Practice 7911382924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Southern California Keck School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cares Community HealthGroup PAC ID 2769418151, 45 clinicians
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

1500 21St St
Sacramento, CA 95811-5216
Phone (916) 443-3299

4860 Y St
Sacramento, CA 95817-2307
Phone (916) 734-8306

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A179554CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Single Specialty Current Accepting new patients
Regents of the Univ of Ca Single Specialty CurrentSince Sep 6, 2022 Accepting new patients
Cares Community Health CurrentSince Aug 19, 2023 Accepting new patients
Cares Community Health Single Specialty CurrentSince Aug 19, 2023 Accepting new patients
Regents of the Univ of Ca Single Specialty CurrentSince Sep 6, 2022 Accepting new patients
Regents of the Univ of Ca Single Specialty Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

1442 Ethan Way
Ste 100
Sacramento, CA 95825
Phone (916) 443-3299

1500 21st St
Sacramento, CA 95811
Phone (916) 443-3299

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 1600
Sacramento, CA 95817
Phone (916) 734-2833

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

Interoperability endpoints

  • Direct secure messaging: malem315723@direct.ochin.org

Organizations & group practices 7

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 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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1275095259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 1600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-3630",
            "fax_number": "916-734-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 1600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-3630",
            "fax_number": "916-734-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEM",
        "first_name": "MONIKANKANA",
        "middle_name": "AYESHA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A179554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.