Individual provider Active NPI

Sanford Jay Brown, MD

  • Family Medicine Physician
  • Fort Bragg, CA
National Provider Identifier
1396851440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G27703 Issued in CA
Practice address
815B Sequoia Circle
Fort Bragg, CA 95437
Phone
(707) 964-9168
Fax
(707) 964-7243
NPI assigned
Aug 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G27703 CA Primary

Addresses

Primary practice location

815B Sequoia Circle
Fort Bragg, CA 95437

Mailing address

815B Sequoia Circle
Fort Bragg, CA 95437
Phone (707) 964-9168

Other identifiers 1

IdentifierTypeStateIssuer
9731118MedicaidCA

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
I20120228000573 CA Practitioner - Family PracticePractitioner - Preventive Medicine 4385802933 Practice locations: Fort Bragg, CA

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Preventive Medicine
Education
Wisconsin College of Physicians and Surgeons, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

815 Sequoia Cir
Suite B
Fort Bragg, CA 95437-5440

815 Sequoia Cir B
Fort Bragg, CA 95437-5440
Phone (707) 964-9168

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
73.31
Promoting interoperability
92
Improvement activities
40
Cost
62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27703CAMDPhysical Therapist

Hospital & facility affiliations 3

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396851440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815B SEQUOIA CIRCLE",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-964-9168",
            "fax_number": "707-964-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815B SEQUOIA CIRCLE",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-964-9168",
            "fax_number": "707-964-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SANFORD",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G27703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9731118",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, CA

Sources for this page

Verify at the official NPI Registry.