Individual provider Active NPI

Melissa Vanover, MD

  • Pediatric Surgery Physician
  • Sacramento, CA
National Provider Identifier
1467886697
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
A134338 Issued in CA
Practice address
2801 K St Ste 220
Sacramento, CA 95816-5118
Phone
(916) 887-4220
NPI assigned
Aug 23, 2013
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A134338 CA
Pediatric Surgery Physician 2086S0120X A134338 CA Primary

Addresses

Primary practice location

2801 K St Ste 220
Sacramento, CA 95816-5118

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Other practice location 1

4301 X St
Sacramento, CA 95817-2214
Phone (916) 734-2011

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
I20200915003696 CA Practitioner - General Surgery 4880012384 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134338CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Sutter Valley Medical Foundation Surgery CurrentSince Oct 9, 2023 Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Oct 9, 2023 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Sutter Regional Medical Foundation Surgery Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2801 K St
Ste 220
Sacramento, CA 95816
Phone (916) 733-8713

Interoperability endpoints

  • Direct secure messaging: mvanover208720@hisp.ehr.sutterhealth.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1467886697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 K ST STE 220",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165118",
            "telephone_number": "916-887-4220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 X St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172214",
            "country_code": "US",
            "telephone_number": "916-734-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANOVER",
        "first_name": "MELISSA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A134338",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "A134338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.