Individual provider Active NPI

Gayle Kikumi Sakaguchi, PA-C, PTA

  • Medical Physician Assistant
  • Lancaster, CA
National Provider Identifier
1538233085
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 17174 Issued in CA
Practice address
1600 W Avenue J
Lancaster, CA 93534-2814
Phone
(661) 949-5115
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT 1215 CA
Surgical Physician Assistant 363AS0400X PA 17174 CA
Medical Physician Assistant 363AM0700X PA 17174 CA Primary

Addresses

Primary practice location

1600 W Avenue J
Lancaster, CA 93534-2814

Mailing address

2139 W 166TH PL
Torrance, CA 90504-2244
Phone (310) 538-2880

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
I20130521000481 CA Practitioner - Physician Assistant 5092953638 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.53 of 100Reported as group
Quality
85.33
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AT 1215CAMDPhysical Therapy Assistant
17174CAMDOccupational Therapist
PA 17174CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians CurrentSince Dec 14, 2019 Accepting new patients
Pih Health Physicians CurrentSince Dec 14, 2019 Accepting new patients
Western Acute Care Physicians, Inc. CurrentSince Apr 15, 2013 Accepting new patients
Western Acute Care Physicians, Inc. Past Accepting new patients

Locations

9838 Paramount Blvd
Downey, CA 90240
Phone (562) 306-5800

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

2623 E Slauson Ave
Walnut Park, CA 90255
Phone (323) 277-5855

Organizations & group practices 9

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1538233085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 W 166TH PL",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905042244",
            "telephone_number": "310-538-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342814",
            "telephone_number": "661-949-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKAGUCHI",
        "first_name": "GAYLE",
        "middle_name": "KIKUMI",
        "credential": "PA-C, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 1215",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA 17174",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 17174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.