Sacramento Plastic & Reconstructive Surgery Medical Group Inc

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

SACRAMENTO PLASTIC & RECONSTRUCTIVE SURGERY MEDICAL GROUP INC

Practice address

95 Scripps Dr
Sacramento, CA 95825-6320

Phone

(916) 929-1833

Fax

(916) 929-6730

NPI assigned

Jul 25, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Marlin G. Schriock

Title

Administrator

Phone

(916) 929-1833

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Plastic Surgery Centerprof Fees2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Plastic Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Sacramento, CA
  • NPI 1134291073
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph R. Coscia, MD

  • Plastic Surgery Physician
  • Sacramento, CA
  • NPI 1982861753
  Medicare reassignment
• Scott Douglas Green, M.D.

  • Plastic Surgery Physician
  • Sacramento, CA
  • NPI 1326110347
  Medicare reassignment
• Wayne Ichiro Yamahata, M.D.

  • Plastic Surgery Physician
  • Sacramento, CA
  • NPI 1942375233
  Medicare reassignment
• Georgina Nichols, M.D.

  • Plastic Surgery Physician
  • Fort Lauderdale, FL
  • NPI 1558781179
  NPD
• Jack G Bruner, M.D.

  • Plastic Surgery Physician
  • Sacramento, CA
  • NPI 1952451759
  NPD (past)

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1487854600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 SCRIPPS DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256320",
            "telephone_number": "916-929-1833",
            "fax_number": "916-929-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 SCRIPPS DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256320",
            "telephone_number": "916-929-1833",
            "fax_number": "916-929-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRAMENTO PLASTIC & RECONSTRUCTIVE SURGERY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SCHRIOCK",
        "authorized_official_first_name": "MARLIN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-929-1833",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sacramento Radiology Medical Group Inc

• Plastic and Reconstructive Surgery Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.