Individual provider Active NPI

Masaharu Sasaki, D.C.,L.AC.

  • Chiropractor
  • Tustin, CA
National Provider Identifier
1720157308
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC16511 Issued in CA
Practice address
17502 Irvine Blvd
Ste a
Tustin, CA 92780-3127
Phone
(714) 665-1354
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC16511 CA Primary

Addresses

Primary practice location

17502 Irvine Blvd
Ste a
Tustin, CA 92780-3127

Mailing address

17502 Irvine Blvd
Ste a
Tustin, CA 92780-3127
Phone (714) 665-1354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101129000214 CA Practitioner - Chiropractic 4688860927 Practice locations: Tustin, CA

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17502 Irvine Blvd
Suite a
Tustin, CA 92780-3127
Phone (714) 665-1354

17502 Irvine Blvd a
Tustin, CA 92780-3127
Phone (714) 665-1354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16511CAMDAddiction (Substance Use Disorder) Counselor
DC16511CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Health Center Chiropractor PastSince Jul 18, 2014 Accepting new patients

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1720157308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17502 IRVINE BLVD",
            "address_2": "STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803127",
            "telephone_number": "714-665-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17502 IRVINE BLVD",
            "address_2": "STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803127",
            "telephone_number": "714-665-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASAKI",
        "first_name": "MASAHARU",
        "credential": "D.C.,L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC16511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.