Individual provider Active NPI

Raymond Anthony Larez Jr., MD MPH

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1275236085
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A205102 Issued in CA
Practice address
4301 X St
Sacramento, CA 95817-2214
Phone
(916) 734-2011
NPI assigned
Mar 22, 2023
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A205102 CA Primary

Addresses

Primary practice location

4301 X St
Sacramento, CA 95817-2214

Mailing address

975 Sereno Dr
Vallejo, CA 94589-2441
Phone (707) 651-4071

Other practice location 1

10535 Hospital Way
Mather, CA 95655-4200
Phone (800) 382-8387

Other practice location 2

975 Sereno Dr
Vallejo, CA 94589-2441
Phone (707) 651-4071

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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
I20260522002295 CA Practitioner - Family Practice 4486162450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5820 Owens Dr
Pleasanton, CA 94588-3900

975 Sereno Dr
Vallejo, CA 94589-2441

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A205102CAMDFamily Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1275236085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 SERENO DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892441",
            "telephone_number": "707-651-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172214",
            "telephone_number": "916-734-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10535 Hospital Way",
            "address_purpose": "LOCATION",
            "city": "Mather",
            "state": "CA",
            "postal_code": "956554200",
            "country_code": "US",
            "telephone_number": "800-382-8387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "975 Sereno Dr",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945892441",
            "country_code": "US",
            "telephone_number": "707-651-4071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAREZ",
        "first_name": "RAYMOND",
        "middle_name": "ANTHONY",
        "name_suffix": "Jr.",
        "credential": "MD MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A205102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "975 Sereno Dr",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945892441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.