Organization Active NPI

Radiological Associates of Sacramento Medical Group Inc

Vascular Surgery Physician
Roseville, CA

National Provider Identifier

1629138300

Registry record updated Oct 27, 2011

On this page

Key facts
NPPES NPI Registry
National Provider Directory
NPI Registry JSON
Other providers in Roseville, CA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name: RADIOLOGICAL ASSOCIATES OF SACRAMENTO MEDICAL GROUP INC
Practice address: 5 Medical Plaza Drive
Suite 140
Roseville, CA 95661
Phone: (916) 783-8114
Fax: (916) 783-8116
NPI assigned: Dec 11, 2006
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Authorized official

Name: Dr. Jonathan Breslau, M.D.
Title: President
Phone: (916) 646-8300

Specialties & licenses 7

Specialty (taxonomy)	Code	Primary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	207U00000X
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	2085B0100X
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	2085N0700X
Pediatric Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	2085P0229X
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	2085R0001X
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	2085U0001X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	2086S0129X	Primary

Addresses

Primary practice location

5 Medical Plaza Drive
Suite 140
Roseville, CA 95661

Mailing address

1500 Expo Pkwy
Sacramento, CA 95815-4227
Phone (916) 646-8300

Other identifiers 1

Identifier	Type	State	Issuer
GR002851P	Medicaid	CA

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1629138300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EXPO PKWY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154227",
            "telephone_number": "916-646-8300",
            "fax_number": "916-920-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PLAZA DRIVE",
            "address_2": "SUITE 140",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-783-8114",
            "fax_number": "916-783-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGICAL ASSOCIATES OF SACRAMENTO MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "BRESLAU",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-646-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Pediatric Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR002851P",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.