Individual provider Active NPI

Sajni Persad

  • Family Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1518700418
Registry record updated Sep 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95032102 Issued in CA
Practice address
3569 Round Barn Cir
Santa Rosa, CA 95403-5781
Phone
(707) 303-3600
NPI assigned
Jun 17, 2024
Last updated
Sep 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95032102 CA Primary
Registered Nurse 163W00000X 95392548 CA

Addresses

Primary practice location

3569 Round Barn Cir
Santa Rosa, CA 95403-5781

Mailing address

3569 Round Barn Cir
Santa Rosa, CA 95403-5781

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
I20241209000844 CA Practitioner - Nurse Practitioner 2860928314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3569 Round Barn Cir
Santa Rosa, CA 95403-5781
Phone (707) 303-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95392548CAMDRegistered Nurse
95032102CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers CurrentSince Oct 3, 2024 Accepting new patients
Santa Rosa Community Health Centers Current Accepting new patients
Santa Rosa Community Health Centers CurrentSince Oct 3, 2024 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

3569 Round Barn Cir
Santa Rosa, CA 95403

Organizations & group practices 4

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": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726358400000",
    "number": "1518700418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035781",
            "telephone_number": "707-303-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAD",
        "first_name": "SAJNI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032102",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95392548",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.