Individual provider Active NPI

Misty Dawn Humphries, M.D.

  • Vascular Surgery Physician
  • Sacramento, CA
National Provider Identifier
1528040870
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A88686 Issued in CA
Practice address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(916) 734-2724
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X A88686 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd
Sacramento, CA 95817-2201

Mailing address

4860 Y Street Suite 3400
Ucdmc Vascular Surgery
Sacramento, CA 95817-2201
Phone (916) 734-2022

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
I20110208000354 CA Practitioner - Vascular SurgeryPractitioner - General PracticePractitioner - General Surgery 5799965745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Texas a & M University System, HSC, College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians
Regents of the University of CaliforniaGroup PAC ID 8022922475, 562 clinicians

Practice addresses (Care Compare)

2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone (916) 734-2680

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

4868 X St
Sacramento, CA 95817-2205

550 W Ranch View Dr
Suite 1200
Rocklin, CA 95765-5398
Phone (916) 295-5810

8110 Laguna Blvd
Elk Grove, CA 95758-8094
Phone (916) 683-3955

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599
  • Adventist Health Sonora Hospital, Sonora, CA, CCN 050335
  • Marshall Medical Center Hospital, Placerville, CA, CCN 050254
  • St Elizabeth Community Hospital Hospital, Red Bluff, CA, CCN 050042
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Merit-based Incentive Payment System (MIPS)

Final score
91.9 of 100Reported as group
Quality
81.89
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal11
Leg revascularization (restoring blood flow)21
Removal of tissue97
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88686CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Jul 1, 2012 Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 1, 2012 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of California CurrentSince Aug 1, 2013 Accepting new patients
Regents of the University of California CurrentSince Aug 1, 2013 Accepting new patients
Essent PRMC LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

6501 Coyle Ave
Carmichael, CA 95608
Phone (916) 537-5000

9390 Big Horn Blvd
Ste 120
Elk Grove, CA 95758

9390 Big Horn Blvd
Elk Grove, CA 95758
Phone (916) 683-3950

8110 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3955

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

4860 Y St
Ste 3400
Sacramento, CA 95817
Phone (916) 734-2022

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2221 Stockton Blvd
Ste E
Sacramento, CA 95817
Phone (916) 734-2680

4860 Y St
Ste 2100
Sacramento, CA 95817
Phone (916) 734-3800

2315 Stockton Blvd
#5
Sacramento, CA 95817
Phone (916) 703-3050

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

4868 X St
Sacramento, CA 95817
Phone (916) 703-1503

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 and National Provider Directory roles.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1528040870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y STREET SUITE 3400",
            "address_2": "UCDMC VASCULAR SURGERY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHRIES",
        "first_name": "MISTY DAWN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A88686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.