Individual provider Active NPI

Sharon Sardar

  • Acute Care Nurse Practitioner
  • Patton, CA
National Provider Identifier
1760171615
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95020970 Issued in CA
Practice address
3102 E Highland Ave
Patton, CA 92369-7813
Phone
(909) 425-7000
NPI assigned
May 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95020970 CA Primary

Addresses

Primary practice location

3102 E Highland Ave
Patton, CA 92369-7813

Mailing address

11413 Ramona Rd
Loma Linda, CA 92354-4183
Phone (909) 714-3964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260527000907 CA Practitioner - Nurse Practitioner 6002386471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11413 Ramona Rd
Loma Linda, CA 92354-4183

PO Box
Suite 451249
Los Angeles, CA 90045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95020970CAMDAcute Care Nurse Practitioner

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": "1683244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1760171615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11413 RAMONA RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923544183",
            "telephone_number": "909-714-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 E HIGHLAND AVE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "923697813",
            "telephone_number": "909-425-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARDAR",
        "first_name": "SHARON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-05-05",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95020970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patton, CA

Sources for this page

Verify at the official NPI Registry.