Individual provider Active NPI

Clarisse Elaine Cadang, M.D.

  • Internal Medicine Physician
  • Fairfield, CA
National Provider Identifier
1588083075
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A145810 Issued in CA
Practice address
4520 Business Center Dr Ste 200
Fairfield, CA 94534-6888
Phone
(707) 646-3500
Fax
(707) 646-3501
NPI assigned
Apr 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0083367 MD
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A145810 CA Primary

Addresses

Primary practice location

4520 Business Center Dr Ste 200
Fairfield, CA 94534-6888

Mailing address

4520 Business Center Dr Ste 200
Fairfield, CA 94534-6888
Phone (707) 646-3500

Other practice location 1

355 Bard Ave
Department of Medicine Villa Bldg1st Floor
Staten Island, NY 10310-1664
Phone (718) 818-2419

Other practice location 2

301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone (410) 767-4000

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
I20200116002477 CA Practitioner - Internal MedicinePractitioner - Hospitalist 6507132628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sycamore Medical Group IncGroup PAC ID 3173585098, 3 clinicians

Practice addresses (Care Compare)

500 Alfred Nobel Dr
Suite 150
Hercules, CA 94547-1842
Phone (510) 741-2111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145810CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sycamore Medical Group Inc Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
Baltimore Washington Medical Center Inc. Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

500 Alfred Nobel Dr
Ste 150
Hercules, CA 94547
Phone (510) 741-2111

Organizations & group practices 5

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 2

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1588083075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 BUSINESS CENTER DR STE 200",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945346888",
            "telephone_number": "707-646-3500",
            "fax_number": "707-646-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 BUSINESS CENTER DR STE 200",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945346888",
            "telephone_number": "707-646-3500",
            "fax_number": "707-646-3501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Bard Ave",
            "address_2": "Department of Medicine Villa Bldg1st Floor",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103101664",
            "country_code": "US",
            "telephone_number": "718-818-2419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210615803",
            "country_code": "US",
            "telephone_number": "410-767-4000",
            "fax_number": "410-595-1933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CADANG",
        "first_name": "CLARISSE",
        "middle_name": "ELAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0083367",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A145810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.