Individual provider Active NPI

Airell Leighton Nygaard, M.D.

  • Orthopaedic Surgery Physician
  • Sonora, CA
National Provider Identifier
1417920760
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
00C37479 Issued in CA
Practice address
680 Guzzi LN
Suite 102
Sonora, CA 95370-5288
Phone
(209) 588-1800
Fax
(209) 588-1700
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 00C37479 CA Primary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 00C37479 CA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 00C37479 CA

Addresses

Primary practice location

680 Guzzi LN
Suite 102
Sonora, CA 95370-5288

Mailing address

680 Guzzi LN
Suite 102
Sonora, CA 95370-5288
Phone (209) 588-1800

Other identifiers 3

IdentifierTypeStateIssuer
00C37479MedicaidCA
00C37479OtherCACA MEDICAL LICENSE #
431973118OtherCACORPORATE TAX ID #

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
I20120703000593 CA Practitioner - Orthopedic Surgery 3870499304 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19033COMDPharmacist
00C37479CAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Community Hospital Current Accepting new patients
Sonora Community Hospital Orthopaedic Surgery CurrentSince Jan 1, 2021 Accepting new patients

Locations

193 Fairview Ln
Sonora, CA 95370
Phone (209) 536-5100

14542 Lolly Ln
Sonora, CA 95370
Phone (209) 536-3625

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1417920760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 GUZZI LN",
            "address_2": "SUITE 102",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705288",
            "telephone_number": "209-588-1800",
            "fax_number": "209-588-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 GUZZI LN",
            "address_2": "SUITE 102",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705288",
            "telephone_number": "209-588-1800",
            "fax_number": "209-588-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYGAARD",
        "first_name": "AIRELL",
        "middle_name": "LEIGHTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "00C37479",
            "primary": true
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "CA",
            "license": "00C37479",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "00C37479",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C37479",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE #",
            "identifier": "00C37479",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE TAX ID #",
            "identifier": "431973118",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.