Individual provider Active NPI

Moh Vang, FNP

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1669185492
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023698 Issued in CA
Practice address
2050 Club Center Dr
Sacramento, CA 95835-1324
Phone
(916) 928-6848
NPI assigned
Dec 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95023698 CA Primary

Addresses

Primary practice location

2050 Club Center Dr
Sacramento, CA 95835-1324

Mailing address

2050 Club Center Dr
Sacramento, CA 95835-1324
Phone (916) 928-6848

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230306002624 CA Practitioner - Nurse Practitioner 4082087481 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berman Skin Institute Medical Group IncGroup PAC ID 0042407215, 26 clinicians

Practice addresses (Care Compare)

1544 Eureka Rd
Suite 160
Roseville, CA 95661-3092
Phone (916) 772-0200

Merit-based Incentive Payment System (MIPS)

Final score
76.8 of 100Reported as group
Quality
65.04
Improvement activities
40
Cost
86.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95023698CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Care CurrentSince Oct 4, 2024 Accepting new patients
Active Life Wound Clinic a Professional Nursing Corporation Current Accepting new patients
Central Health Plan of California, Inc. CurrentSince Oct 4, 2024 Accepting new patients
Berman Skin Institute Medical Group Inc CurrentSince Sep 8, 2025 Accepting new patients
Molina Healthcare of California CurrentSince Sep 23, 2024 Accepting new patients

Locations

3581 Palmer Dr
Ste 203
Cameron Park, CA 95682
Phone (530) 676-0119

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

5575 W Las Positas Blvd
Ste 220
Pleasanton, CA 94588
Phone (650) 325-6000

1544 Eureka Rd
Ste 160
Roseville, CA 95661
Phone (916) 772-0200

1792 Tribute Rd
Ste 200
Sacramento, CA 95815
Phone (916) 678-5400

1 Daniel Burnham Ct
Ste 350C
San Francisco, CA 94109
Phone (415) 771-6300

100 Pringle Ave
Ste 425
Walnut Creek, CA 94596
Phone (925) 932-3800

1166 Live Oak Blvd
Yuba City, CA 95991
Phone (530) 751-1500

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.

NPI Registry JSON

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

{
    "created_epoch": "1672012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1669185492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 CLUB CENTER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351324",
            "telephone_number": "916-928-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 CLUB CENTER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351324",
            "telephone_number": "916-928-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "MOH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-26",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.