NPIMap

Organization Active NPI

Regents of the Univ of Ca

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Sacramento, CA
National Provider Identifier
1285068783
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
Legal business name
REGENTS OF THE UNIV OF CA
Practice address
4860 Y St
Sacramento, CA 95817-2307
Phone
(916) 734-6483
Fax
(916) 734-6666
NPI assigned
Sep 3, 2013
Last updated
Mar 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Authorized official

Name
Mr. James D Kirk, MD
Title
Cmo
Phone
(916) 734-1166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X NU Primary

Addresses

Primary practice location

4860 Y St
Sacramento, CA 95817-2307

Mailing address

4900 Broadway
Suite 2800
Sacramento, CA 95820-1532
Phone (916) 734-9200

Other names 1

  • Regents UCDPBG UroGyn Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000892 CA Part B Supplier - Clinic/Group Practice 3375456619 Receives reassigned benefits from 2,647 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Im General Medprof GP57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

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

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395360000000",
    "number": "1285068783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 BROADWAY",
            "address_2": "SUITE 2800",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201532",
            "telephone_number": "916-734-9200",
            "fax_number": "916-734-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-6483",
            "fax_number": "916-734-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIV OF CA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2014-03-21",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "916-734-1166",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regents UCDPBG UroGyn",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.