Individual provider Active NPI

Shaan Ludder, D.O.

  • Neurology Physician
  • Sacramento, CA
National Provider Identifier
1689106502
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
20A17220 Issued in CA
Practice address
2800 L St
Sacramento, CA 95816-5616
Phone
(916) 454-6850
NPI assigned
Mar 30, 2017
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 20A17220 CA Primary

Addresses

Primary practice location

2800 L St
Sacramento, CA 95816-5616

Mailing address

PO Box 276950
Sacramento, CA 95827-6950

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
I20220817002421 CA Practitioner - Neurology 0345623716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

200 Mission Blvd
Jackson, CA 95642-2564
Phone (916) 733-3777

2800 L St
Sacramento, CA 95816-5616

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

800 E Washington Blvd
Crescent City, CA 95531-8359
Phone (707) 464-8511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A17220CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Neurology Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 1, 2022 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 1, 2022 Accepting new patients
Sutter Tracy Community Hospital Past Accepting new patients
Memorail Hospital of Los Banos Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: sludder628273@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1689106502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276950",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958276950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 L ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165616",
            "telephone_number": "916-454-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDDER",
        "first_name": "SHAAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "20A17220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.