Individual provider Active NPI

Bryan Sauter, PAC

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1407944820
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13253 Issued in CA
Practice address
311 E Winston Street
Los Angeles Mission Community Clinic
Los Angeles, CA 90013
Phone
(213) 893-1960
Fax
(213) 893-1962
NPI assigned
Oct 11, 2006
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
Physician Assistant 363A00000X PA13253 CA Primary

Addresses

Primary practice location

311 E Winston Street
Los Angeles Mission Community Clinic
Los Angeles, CA 90013

Mailing address

23544 Ash CT
Marrieta, CA 92562
Phone (951) 698-4644

Other identifiers 2

IdentifierTypeStateIssuer
EAP70948FOtherCAEAPC
CMM70948FMedicaidCA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081118000401 CA Practitioner - Physician Assistant 1850451048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Albany Medical College of Union University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Medical DoctorsGroup PAC ID 2961305651, 168 clinicians

Practice addresses (Care Compare)

16405 Sand Canyon Ave
Suite 250
Irvine, CA 92618-3787
Phone (949) 502-5572

2083 Compton Ave
Suite 104
Corona, CA 92881-7288
Phone (951) 837-3151

28078 Baxter Rd
Suite 530
Murrieta, CA 92563-1405
Phone 9515665229125

400 Newport Ctr Dr
Suite 609
Newport Beach, CA 92660-7695
Phone (949) 760-0398

40663 Murrieta Hot Springs Rd
Suite C1
Murrieta, CA 92562-9015
Phone (951) 200-6791

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13253CAMDProfessional Counselor
PA13253CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Doctors CurrentSince Sep 1, 2019 Accepting new patients

Locations

2083 Compton Ave
Ste 104
Corona, CA 92881
Phone (951) 256-8191

521 E Elder St
Ste 104
Fallbrook, CA 92028
Phone (760) 728-9560

40663 Murrieta Hot Springs Rd
Ste C1
Murrieta, CA 92562
Phone (951) 200-6791

28078 Baxter Rd
Ste 530
Murrieta, CA 92563
Phone (951) 290-5472

400 Newport Center Dr
Ste 609
Newport Beach, CA 92660
Phone (949) 760-0398

31469 Rancho Pueblo Rd
Ste 101
Temecula, CA 92592
Phone (951) 303-3718

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407944820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23544 ASH CT",
            "city": "MARRIETA",
            "state": "CA",
            "postal_code": "92562",
            "telephone_number": "951-698-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E WINSTON STREET",
            "address_2": "LOS ANGELES MISSION COMMUNITY CLINIC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90013",
            "telephone_number": "213-893-1960",
            "fax_number": "213-893-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUTER",
        "first_name": "BRYAN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAPC",
            "identifier": "EAP70948F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70948F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.