Individual provider Active NPI

Abby Stretch

  • Medical Physician Assistant
  • Roseville, CA
National Provider Identifier
1609269927
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
52322 Issued in CA
Practice address
4010 Foothills Blvd Ste 102
Roseville, CA 95747-7241
Phone
(800) 972-5547
NPI assigned
Mar 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 52322 CA Primary

Addresses

Primary practice location

4010 Foothills Blvd Ste 102
Roseville, CA 95747-7241

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

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
I20150722004339 CA Practitioner - Physician Assistant 1759694581 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2702 Low CT
Fairfield, CA 94534-9771
Phone (707) 432-2600

2720 Low CT
Fairfield, CA 94534-9771
Phone (707) 428-2731

2800 L St
Sacramento, CA 95816-5616

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Nov 16, 2020 Accepting new patients
Cep America - California CurrentSince Aug 1, 2015 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Nov 16, 2020 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

5406 Sunrise Blvd
Ste 4
Citrus Heights, CA 95610

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

2766 E Bidwell St
Ste H600
Folsom, CA 95630

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4010 Foothills Blvd
Ste 102
Roseville, CA 95747
Phone (916) 689-4111

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: astretch341646@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1609269927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 FOOTHILLS BLVD STE 102",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957477241",
            "telephone_number": "800-972-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRETCH",
        "first_name": "ABBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "52322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.