Individual provider Active NPI

Emanuele Maccalli, MD

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1700289261
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A142185 Issued in CA
Practice address
2400 Glendale LN
Sacramento, CA 95825-2431
Phone
(916) 454-2345
NPI assigned
Sep 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A142185 CA Primary

Addresses

Primary practice location

2400 Glendale LN
Sacramento, CA 95825-2431

Mailing address

PO Box 53812
San Jose, CA 95153-0812

Other practice location 1

2516 Stockton Blvd
Sacramento, CA 95817-2208
Phone (916) 734-2428

Other practice location 2

2465 Latham St Ste 300
Mountain View, CA 94040-4792
Phone (912) 244-9474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A142185CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtap Medical Group, P.C. CurrentSince Apr 1, 2021 Accepting new patients

Locations

2465 Latham St
Ste 300
Mountain View, CA 94040
Phone (650) 268-9806

Interoperability endpoints

  • Direct secure messaging: emaccalli78678@valleychildrens-prd.direct-ci.com

Organizations & group practices 1

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": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1700289261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53812",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951530812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 GLENDALE LN",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252431",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2516 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172208",
            "country_code": "US",
            "telephone_number": "916-734-2428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2465 Latham St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "940404792",
            "country_code": "US",
            "telephone_number": "912-244-9474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACCALLI",
        "first_name": "EMANUELE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-29",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A142185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.