Active NPI
Mark Trent Sylvester, MD
- Orthopaedic Surgery Physician
- Auburn, CA
National Provider Identifier
1578629317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G75212
- Practice address
- 12719 Shockley Woods Court
Auburn, CA 95603 - Phone
- (916) 764-0733
- Fax
- (530) 887-0348
- NPI assigned
- Dec 28, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | G75212 | CA | Primary |
Addresses
Primary practice location
12719 Shockley Woods Court
Auburn, CA 95603
Mailing address
PO Box 9236
Auburn, CA 95604-9236
Phone (916) 764-0733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G752122 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G75212 | CA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578629317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9236",
"city": "AUBURN",
"state": "CA",
"postal_code": "956049236",
"telephone_number": "916-764-0733",
"fax_number": "530-887-0348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12719 SHOCKLEY WOODS COURT",
"city": "AUBURN",
"state": "CA",
"postal_code": "95603",
"telephone_number": "916-764-0733",
"fax_number": "530-887-0348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYLVESTER",
"first_name": "MARK",
"middle_name": "TRENT",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G75212",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G752122",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.