Individual provider Active NPI

Daniel Klug, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1336651967
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95007123 Issued in CA
Practice address
1485 River Park Dr Ste 200
Sacramento, CA 95815-4530
Phone
(916) 679-3590
Fax
(916) 482-3647
NPI assigned
Nov 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95007123 CA Primary

Addresses

Primary practice location

1485 River Park Dr Ste 200
Sacramento, CA 95815-4530

Mailing address

1300 Ethan Way Ste 600
Sacramento, CA 95825-2296
Phone (916) 679-3590

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180313001009 CA Practitioner - Nurse Practitioner 5890057731 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone (916) 734-2680

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95007123CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Mar 30, 2020 Accepting new patients
Pulmonary Medicine Associates Sleep Lab Inc. CurrentSince May 1, 2018 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Mar 30, 2020 Accepting new patients
Pulmonary Medicine Associates Medical Group, Inc CurrentSince May 1, 2018 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2221 Stockton Blvd
Ste E
Sacramento, CA 95817
Phone (916) 734-2680

1300 Ethan Way
Ste 600
Sacramento, CA 95825
Phone (916) 482-7623

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

1485 River Park Dr
Ste 200
Sacramento, CA 95815
Phone (916) 325-1040

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

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 and National Provider Directory roles.

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": "1509840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1336651967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 ETHAN WAY STE 600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252296",
            "telephone_number": "916-679-3590",
            "fax_number": "916-679-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 RIVER PARK DR STE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154530",
            "telephone_number": "916-679-3590",
            "fax_number": "916-482-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUG",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-05",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95007123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.