Active NPI
Russell E. Consiglio, P.A.
- Dermatology Physician
- Sacramento, CA
National Provider Identifier
1346256369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- PA10894
- Practice address
- 3160 Folsom Blvd
Sacramento, CA 95816-5219 - Phone
- (916) 733-5336
- Fax
- (916) 733-5385
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | PA10894 | CA | Primary |
Addresses
Primary practice location
3160 Folsom Blvd
Sacramento, CA 95816-5219
Mailing address
2914 58TH St
Sacramento, CA 95817-1741
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4663625 | Other | CA | AETNA |
| 6753334 | Other | CA | CIGNA |
| 461130 | Other | CA | INTERPLAN |
| 90078280 | Other | CA | PACIFICARE |
| PA10894 | Medicaid | CA | |
| 10899748 | Other | CA | GREAT WEST |
| PA10894 | Other | CA | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10894 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346256369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2914 58TH ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958171741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3160 FOLSOM BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165219",
"telephone_number": "916-733-5336",
"fax_number": "916-733-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONSIGLIO",
"first_name": "RUSSELL",
"middle_name": "E.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "PA10894",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4663625",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6753334",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERPLAN",
"identifier": "461130",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE",
"identifier": "90078280",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PA10894",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "10899748",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "PA10894",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.