Active NPI
Jonathan Budhram, PA-C
- Physician Assistant
- Sacramento, CA
National Provider Identifier
1740936301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 60268
- Practice address
- 4700 Northgate Blvd Ste 100
Sacramento, CA 95834-1149 - Phone
- (916) 929-6161
- NPI assigned
- Feb 23, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 60268 | CA | Primary |
Addresses
Primary practice location
4700 Northgate Blvd Ste 100
Sacramento, CA 95834-1149
Mailing address
4700 Northgate Blvd Ste 100
Sacramento, CA 95834-1149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60268 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702598400000",
"number": "1740936301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 NORTHGATE BLVD STE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958341149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 NORTHGATE BLVD STE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958341149",
"telephone_number": "916-929-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUDHRAM",
"first_name": "JONATHAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-23",
"last_updated": "2023-12-15",
"certification_date": "2023-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "60268",
"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 Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.