Individual provider Active NPI

Ratnaji Babu Nallamothu, M.D.

  • Specialist
  • Sacramento, CA
National Provider Identifier
1407877608
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A69392 Issued in CA
Practice address
777 Campus Commons Rd
Suite 120
Sacramento, CA 95825-8309
Phone
(916) 929-8564
Fax
(916) 929-4529
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A69392 CA Primary

Addresses

Primary practice location

777 Campus Commons Rd
Suite 120
Sacramento, CA 95825-8309

Mailing address

777 Campus Commons Rd
Suite 120
Sacramento, CA 95825-8309
Phone (916) 929-8564

Other identifiers 2

IdentifierTypeStateIssuer
390006482OtherRAILROAD MEDICARE
GR0015060MedicaidCA

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
I20060919000366 CA Practitioner - Nephrology 8527080753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Saint Louis University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Nephrology Medical GroupGroup PAC ID 5799736427, 22 clinicians

Practice addresses (Care Compare)

1111 Exposition Blvd
Suite 300
Sacramento, CA 95815-4324
Phone (916) 564-6232

Hospital & facility affiliations

  • DaVita West Sacramento Dialysis Center Dialysis facility, West Sacramento, CA, CCN 552591
  • DaVita University Dialysis Center Dialysis facility, Sacramento, CA, CCN 552549
  • DaVita Joy of Dixon Dialysis Center Dialysis facility, Dixon, CA, CCN 552603
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Nephrology Medical Group Specialist CurrentSince Apr 1, 2006 Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Natomas Dialysis LLC PastSince Nov 22, 2024 Accepting new patients

Locations

2218 Kausen Dr
Ste 103
Elk Grove, CA 95758
Phone (916) 683-8774

1111 Exposition Blvd
Ste 300
Sacramento, CA 95815
Phone (916) 564-6232

333 University Ave
Ste 120
Sacramento, CA 95825
Phone (916) 929-8564

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 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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1407877608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CAMPUS COMMONS RD",
            "address_2": "SUITE 120",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958258309",
            "telephone_number": "916-929-8564",
            "fax_number": "916-929-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CAMPUS COMMONS RD",
            "address_2": "SUITE 120",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958258309",
            "telephone_number": "916-929-8564",
            "fax_number": "916-929-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLAMOTHU",
        "first_name": "RATNAJI",
        "middle_name": "BABU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A69392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390006482",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0015060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.