Individual provider Active NPI

Fatema Shahabuddin Mollah, MD

  • Allergy & Immunology Physician
  • Sacramento, CA
National Provider Identifier
1346803269
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
A183390 Issued in CA
Practice address
4860 Y St Ste 2400
Sacramento, CA 95817-2307
Phone
(916) 734-6602
NPI assigned
Apr 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X A183390 CA Primary

Addresses

Primary practice location

4860 Y St Ste 2400
Sacramento, CA 95817-2307

Mailing address

4860 Y St Ste 2400
Sacramento, CA 95817-2307

Other practice location 1

10535 Hospital Way # T8
Mather, CA 95655-4200
Phone (916) 843-7000

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
I20241231000974 CA Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 7911383013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A183390CAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Jan 1, 2025 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Jan 1, 2025 Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

4860 Y St
Ste 400
Sacramento, CA 95817
Phone (916) 734-1482

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 2400
Sacramento, CA 95817
Phone (916) 734-6602

Organizations & group practices 3

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": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1346803269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 2400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 2400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-6602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10535 Hospital Way # T8",
            "address_purpose": "LOCATION",
            "city": "Mather",
            "state": "CA",
            "postal_code": "956554200",
            "country_code": "US",
            "telephone_number": "916-843-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLLAH",
        "first_name": "FATEMA",
        "middle_name": "SHAHABUDDIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A183390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.