NPIMap

Organization Active NPI

Sacsolano Anesthesia Exchange Medical Group, Inc

  • Anesthesiology Physician
  • Sacramento, CA
National Provider Identifier
1720401284
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SACSOLANO ANESTHESIA EXCHANGE MEDICAL GROUP, INC
Practice address
3315 Watt Ave
Sacramento, CA 95821-3600
Phone
(916) 481-6800
Fax
(916) 481-1881
NPI assigned
Feb 3, 2014
Last updated
Feb 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Authorized official

Name
Tom Hallum, M.D., D.O
Title
Ceo
Phone
(916) 481-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X CA Primary

Addresses

Primary practice location

3315 Watt Ave
Sacramento, CA 95821-3600

Mailing address

PO Box 660910
Sacramento, CA 95866-0910
Phone (916) 481-6800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140514001267 CA Part B Supplier - Clinic/Group Practice 9537382882 Receives reassigned benefits from 62 practitioners
Practice locations: Sacramento, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 279

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 279

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1720401284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660910",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958660910",
            "telephone_number": "916-481-6800",
            "fax_number": "916-481-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 WATT AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213600",
            "telephone_number": "916-481-6800",
            "fax_number": "916-481-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACSOLANO ANESTHESIA EXCHANGE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-03",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "HALLUM",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-481-6800",
        "authorized_official_credential": "M.D., D.O"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.