NPIMap

Individual provider Active NPI

Ehsan Sultani, MD

  • Family Medicine Physician
  • Elk Grove, CA
National Provider Identifier
1699853317
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A49614 Issued in CA
Practice address
9381 E Stockton Blvd Ste 220
Elk Grove, CA 95624-5070
Phone
(916) 667-8520
Fax
(916) 667-8635
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X A49614 CA
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X A49614 CA
Family Medicine Physician 207Q00000X A49614 CA Primary

Addresses

Primary practice location

9381 E Stockton Blvd Ste 220
Elk Grove, CA 95624-5070

Mailing address

9381 E Stockton Blvd Ste 220
Elk Grove, CA 95624-5070
Phone (916) 667-8520

Other identifiers 1

IdentifierTypeStateIssuer
1699853317OtherCAFAMILY MEDICINE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110203000153 CA Practitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 5698955979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine, Hospice/Palliative Care
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2366 Gold Meadow Way
Suite 100
Gold River, CA 95670-4471
Phone (916) 667-8520

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49614CAMDPharmacist
A49614CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Essential Health Inc Hospice and Palliative Medicine CurrentSince Apr 22, 2017 Accepting new patients
All Inclusive Medical Services, Inc Family Medicine CurrentSince Nov 21, 2016 Accepting new patients
Dignity Community Care Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Newstart Medical Group Inc Hospice and Palliative Medicine Past Accepting new patients

Locations

5900 Coyle Ave
Ste A
Carmichael, CA 95608
Phone (916) 330-4447

9381 E Stockton Blvd
Ste 220
Elk Grove, CA 95624
Phone (916) 667-8520

2366 Gold Meadow Way
Ste 100
Gold River, CA 95670
Phone (510) 394-0280

2233 Watt Ave
Ste 340
Sacramento, CA 95825

Interoperability endpoints

  • Direct secure messaging: esultani362145@hisp.ehr.sutterhealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Interim Healthcare Hospice - Sacramento AreaGold River, CA, CCN A11783 Hospice Contracted Managing Employee (33%) May 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 7

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699853317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9381 E STOCKTON BLVD STE 220",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245070",
            "telephone_number": "916-667-8520",
            "fax_number": "916-667-8635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9381 E STOCKTON BLVD STE 220",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245070",
            "telephone_number": "916-667-8520",
            "fax_number": "916-667-8635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTANI",
        "first_name": "EHSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A49614",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A49614",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A49614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY MEDICINE",
            "identifier": "1699853317",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.