Individual provider Active NPI

Kristin Bennett, D.O.

  • Anesthesiology Physician
  • Sacramento, CA
National Provider Identifier
1578627642
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
10800 Issued in CA
Practice address
4150 V St
Patient Support Services Building Suite 1200
Sacramento, CA 95817-1460
Phone
(916) 734-5031
Fax
(916) 734-7980
NPI assigned
Dec 21, 2006
Last updated
Jun 11, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 10800 CA Primary

Addresses

Primary practice location

4150 V St
Patient Support Services Building Suite 1200
Sacramento, CA 95817-1460

Mailing address

4150 V St
Patient Support Services Building Suite 1200
Sacramento, CA 95817-1460
Phone (916) 734-5031

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
I20120523000271 CA Practitioner - Anesthesiology 9133382567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Dorado Anesthesia Medical GroupGroup PAC ID 2163314048, 15 clinicians
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

1100 Marshall Way
Placerville, CA 95667-6533
Phone (530) 622-1441

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

Hospital & facility affiliations

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
El Dorado Anesthesia Medical Group Anesthesiology CurrentSince Feb 5, 2021 Accepting new 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 Past Accepting new patients
UC Davis Medical Center Past Accepting new patients

Locations

1100 Marshall Way
Placerville, CA 95667
Phone (530) 626-2601

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

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

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

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1578627642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "PATIENT SUPPORT SERVICES BUILDING SUITE 1200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-5031",
            "fax_number": "916-734-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "PATIENT SUPPORT SERVICES BUILDING SUITE 1200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-5031",
            "fax_number": "916-734-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KRISTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "10800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.