Individual provider Active NPI

Alissa Sabatino Shepard, DO

  • Emergency Medicine Physician
  • Stockton, CA
National Provider Identifier
1417539230
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A21055 Issued in CA
Practice address
1800 N California St
Stockton, CA 95204-6019
Phone
(209) 943-2000
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R3630 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 20A21055 CA Primary

Addresses

Primary practice location

1800 N California St
Stockton, CA 95204-6019

Mailing address

2512 Chardonnay LN
Lodi, CA 95242-8201
Phone (602) 819-1145

Other names 1

  • Dr. Alissa Marie Sabatino Former name

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
I20240617003967 CA Practitioner - Emergency Medicine 1052854130 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Francisco Physicians International Medical Group IncGroup PAC ID 5597679225, 39 clinicians
Team Physicians of California Medical Group IncGroup PAC ID 8224945084, 92 clinicians

Practice addresses (Care Compare)

1800 N California St
Stockton, CA 95204-6019
Phone (209) 467-6556

Hospital & facility affiliations

  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
  • Adventist Health Lodi Memorial Hospital, Lodi, CA, CCN 050336

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A21055CAMDEmergency Medicine Physician
R3630AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
San Joaquin Emergency Medical Associates Emergency Medicine CurrentSince Jul 23, 2024 Accepting new patients
San Francisco Physicians International Medical Group, Inc Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

6001 Norris Canyon Rd
San Ramon, CA 94583
Phone (925) 275-8273

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

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 2

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": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1417539230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 CHARDONNAY LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952428201",
            "telephone_number": "602-819-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-943-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "ALISSA",
        "middle_name": "SABATINO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "R3630",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A21055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISSA",
            "last_name": "SABATINO",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.