Individual provider Active NPI

Alan G McNabb, MD

  • Surgery Physician
  • Roseville, CA
National Provider Identifier
1629173745
Registry record updated Jun 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G66808 Issued in CA
Practice address
5 Medical Plaza Dr.
Suite 120
Roseville, CA 95661
Phone
(916) 781-2500
Fax
(916) 782-9424
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G66808 CA Primary

Addresses

Primary practice location

5 Medical Plaza Dr.
Suite 120
Roseville, CA 95661

Mailing address

5 Medical Plaza Dr.
Suite 120
Roseville, CA 95661
Phone (916) 781-2500

Other identifiers 1

IdentifierTypeStateIssuer
00G668980MedicaidCA

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
I20080930000392 CA Practitioner - General Surgery 3173690328 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G66808CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma Medical Group of Roseville Inc CurrentSince Aug 10, 2009 Accepting new patients

Locations

2 Medical Plaza Dr
Ste 275
Roseville, CA 95661
Phone (916) 462-8410

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

Organizations & group practices 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497571200000",
    "number": "1629173745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PLAZA DR.",
            "address_2": "SUITE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-781-2500",
            "fax_number": "916-782-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PLAZA DR.",
            "address_2": "SUITE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-781-2500",
            "fax_number": "916-782-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNABB",
        "first_name": "ALAN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2017-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G66808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G668980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.