Individual provider Active NPI

Emmanuel De Jesus, M.D.

  • Internal Medicine Physician
  • Sacramento, CA
National Provider Identifier
1356729388
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A146470 Issued in CA
Practice address
1201 Alhambra Blvd Ste 400
Sacramento, CA 95816-5243
Phone
(916) 733-8725
NPI assigned
May 11, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A146470 CA Primary

Addresses

Primary practice location

1201 Alhambra Blvd Ste 400
Sacramento, CA 95816-5243

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (916) 708-8038

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
I20181226002059 CA Practitioner - Internal Medicine 5496090219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

100 Mission Blvd
Jackson, CA 95642-2536

2 Medical Plaza Dr
Roseville, CA 95661-3042

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A146470CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Internal Medicine Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jan 1, 2021 Accepting new patients
Sutter Valley Medical Foundation Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

7 Medical Plaza Dr
Ste 170
Roseville, CA 95661
Phone (916) 755-7090

1201 Alhambra Blvd
Ste 400
Sacramento, CA 95816
Phone (916) 733-5090

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: edejesus299036@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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 4

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": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1356729388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "916-708-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ALHAMBRA BLVD STE 400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165243",
            "telephone_number": "916-733-8725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "EMMANUEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A146470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.