Individual provider Active NPI

Alexander Lister, DPM

  • Foot & Ankle Surgery Podiatrist
  • Carmichael, CA
National Provider Identifier
1649732769
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
EL6850 Issued in CA
Practice address
5120 Manzanita Ave Ste 100
Carmichael, CA 95608-0590
Phone
(916) 459-4398
NPI assigned
Apr 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X EL6850 CA Primary

Addresses

Primary practice location

5120 Manzanita Ave Ste 100
Carmichael, CA 95608-0590

Mailing address

5120 Manzanita Ave Ste 100
Carmichael, CA 95608-0590
Phone (916) 705-4135

Other practice location 1

4097 Solaire Dr
Roseville, CA 95747-8760
Phone (916) 705-4135

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200109002544 CA Practitioner - Podiatry 4587099072 Reassigns benefits to 1 organization
Practice locations: Stockton, CA; Roseville, CA; San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Western University of Health Sciences College of Dental Med, 2017
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)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue97
Removal of skin lesions1-10
Removal of nail tissue210
Removal or shaving of skin growth136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
EL6850CAMDFoot & Ankle Surgery Podiatrist
5605CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Jan 1, 2023 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jan 1, 2023 Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Dignity Health Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

8170 Laguna Blvd
Ste 105
Elk Grove, CA 95758
Phone (916) 684-7505

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

Interoperability endpoints

  • Direct secure messaging: alister557233@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.

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1649732769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 MANZANITA AVE STE 100",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080590",
            "telephone_number": "916-705-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 MANZANITA AVE STE 100",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080590",
            "telephone_number": "916-459-4398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4097 SOLAIRE DR",
            "address_purpose": "LOCATION",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957478760",
            "country_code": "US",
            "telephone_number": "916-705-4135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISTER",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "EL6850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.