Individual provider Active NPI

Ananya Datta Mitra

  • Anatomic Pathology & Clinical Pathology Physician
  • Sacramento, CA
National Provider Identifier
1649651027
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A150441 Issued in CA
Practice address
4400 V St
Sacramento, CA 95817-1445
Phone
(916) 734-2525
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A150441 CA Primary

Addresses

Primary practice location

4400 V St
Sacramento, CA 95817-1445

Mailing address

4400 V St
Sacramento, CA 95817-1445
Phone (916) 734-2525

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
I20200526003011 CA Practitioner - Pathology 8729409966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2657

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A150441CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Ca CurrentSince Jul 1, 2020 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 1, 2020 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

4400 V St
Sacramento, CA 95817
Phone (916) 734-2525

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

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 3

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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1649651027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 V ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171445",
            "telephone_number": "916-734-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 V ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171445",
            "telephone_number": "916-734-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTA MITRA",
        "first_name": "ANANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A150441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.