Active NPI
Ethan Gabriel Cermeno, MD
- Internal Medicine Physician
- Sacramento, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 18467
- Practice address
- 4150 V St # 1100
Sacramento, CA 95817-1460 - Phone
- (818) 438-8107
- NPI assigned
- Aug 26, 2018
- Last updated
- Feb 4, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 18467 | CA | Primary |
| Psychiatry Physician | 2084P0800X | 18467 | CA |
Addresses
Primary practice location
4150 V St # 1100
Sacramento, CA 95817-1460
Mailing address
4150 V St # 1100
Sacramento, CA 95817-1460
Phone (916) 734-2737
Other practice location 1
4610 X St
Sacramento, CA 95817-2200
Phone (916) 734-4111
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of California, Davis School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
250 W Main St
Woodland, CA 95695-3652
Phone (916) 668-6100
2800 L St
Sacramento, CA 95816-5616
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Medical Foundation | Internal Medicine | Current | Accepting new patients |
| Sutter Valley Medical Foundation | Current | Accepting new patients | |
| Sutter Valley Medical Foundation | Internal Medicine | Current | Accepting new patients |
| Sutter Regional Medical Foundation | Internal Medicine | 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
1201 Alhambra Blvd
Ste 420
Sacramento, CA 95816
Phone (916) 731-7707
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
7919 Folsom Blvd
Ste 180
Sacramento, CA 95826
Phone (916) 887-7890
250 W Main St
Woodland, CA 95695
Phone (916) 668-6100
Interoperability endpoints
- ecermeno312454@direct.ochin.org
- ecermeno747730@hisp.ehr.sutterhealth.org
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.
-
dba Sutter Gould Medical Foundation
- Multi-Specialty Clinic/Center
- Modesto, CA
- NPI 1669846986
Internal Medicine
-
- Durable Medical Equipment & Medical Supplies
- Tracy, CA
- NPI 1720930712
-
- Multi-Specialty Clinic/Center
- Sacramento, CA
- NPI 1952327256
Internal Medicine
-
- Family Medicine Physician
- Fairfield, CA
- NPI 1558388504
Internal Medicine
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sacramento, CA
- NPI 1811946734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738627200000",
"number": "1538640776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 V ST # 1100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958171460",
"telephone_number": "916-734-2737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 V ST # 1100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958171460",
"telephone_number": "818-438-8107"
}
],
"practiceLocations": [
{
"address_1": "4610 X St",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958172200",
"country_code": "US",
"telephone_number": "916-734-4111",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CERMENO",
"first_name": "ETHAN",
"middle_name": "GABRIEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-26",
"last_updated": "2025-02-04",
"certification_date": "2025-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "18467",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "18467",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.