Individual provider Active NPI

Ricardo H Bardales, MD

  • Anatomic Pathology Physician
  • Sacramento, CA
National Provider Identifier
1326083809
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
C52141 Issued in CA
Practice address
7750 College Town Dr
102
Sacramento, CA 95826-2356
Phone
(916) 444-0889
Fax
(916) 444-6016
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X C52141 CA Primary

Addresses

Primary practice location

7750 College Town Dr
102
Sacramento, CA 95826-2356

Mailing address

7750 College Town Dr
102
Sacramento, CA 95826-2356
Phone (916) 444-0889

Other identifiers 1

IdentifierTypeStateIssuer
GR0029350MedicaidCA

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
I20060426000342 CA Practitioner - Pathology 1254341993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
53.37 of 100Reported as group
Quality
41.06
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52141CAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yosemite Pathology Medical Group, Inc CurrentSince Jun 5, 2017 Accepting new patients
Yosemite Pathology Medical Group, in Past Accepting new patients

Locations

4301 N Star Way
Ste A
Modesto, CA 95356

6001 Norris Canyon Rd
San Ramon, CA 94583
Phone (925) 275-8273

Organizations & group practices 2

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1326083809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 COLLEGE TOWN DR",
            "address_2": "102",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262356",
            "telephone_number": "916-444-0889",
            "fax_number": "916-444-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 COLLEGE TOWN DR",
            "address_2": "102",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262356",
            "telephone_number": "916-444-0889",
            "fax_number": "916-444-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDALES",
        "first_name": "RICARDO",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "C52141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0029350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.