Ken Soderlund Sato, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

G85728 Issued in CA

Practice address

352 Alta Ave
Santa Cruz, CA 95060-6442

Phone

(831) 401-2313

Fax

(831) 401-2313

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270598400000",
    "number": "1306835012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 ALMAR AVE",
            "address_2": "SUITE C, #169",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605875",
            "telephone_number": "831-401-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 ALTA AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950606442",
            "telephone_number": "831-401-2313",
            "fax_number": "831-401-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATO",
        "first_name": "KEN",
        "middle_name": "SODERLUND",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2010-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G85728",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OR",
            "license": "MD24401",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "HI",
            "license": "10583",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297482",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G857280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen Sass
• Ryan Sass
• Vibha Sastry
• Satellite Healthcare Inc
• Hanahlie Sato
• Shawna Louise Saubers-Ristic, LMT
• Sarah Elizabeth Saulnier
• Neil Sawhney, MD
• Scott M Sawyer, DC
• Jennifer Saxe

• Neurological Surgery Physician in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.