Individual provider Active NPI

Sydnie Ann Tabernilla Espiritu, MD

  • Internal Medicine Physician
  • Sylmar, CA
National Provider Identifier
1669009940
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A177479 Issued in CA
Practice address
14445 Olive View Dr # 2B182
Sylmar, CA 91342-1437
Phone
(747) 210-3205
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Internal Medicine Physician 207R00000X A177479 CA Primary

Addresses

Primary practice location

14445 Olive View Dr # 2B182
Sylmar, CA 91342-1437

Mailing address

14445 Olive View Dr # 2B182
Sylmar, CA 91342-1437
Phone (747) 210-3205

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
I20230828002121 CA Practitioner - Internal Medicine 7113321225 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177479CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sacramento CurrentSince Jul 1, 2023 Accepting new patients
County of Sacramento CurrentSince Jul 1, 2023 Accepting new patients

Locations

4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670

4600 Broadway
Ste 2500
Sacramento, CA 95820

4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670

Interoperability endpoints

  • Direct secure messaging: sespiritu312456@direct.ochin.org

Organizations & group practices 2

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1669009940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR # 2B182",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "747-210-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR # 2B182",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "747-210-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPIRITU",
        "first_name": "SYDNIE ANN",
        "middle_name": "TABERNILLA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A177479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.