Individual provider Active NPI

Summer R Youker

  • MOHS-Micrographic Surgery Physician
  • Sacramento, CA
National Provider Identifier
1760409742
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
C53335 Issued in CA
Practice address
2805 J St Ste 100
Sacramento, CA 95816-4307
Phone
(916) 492-1828
Fax
(916) 492-1834
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X C53335 CA Primary

Addresses

Primary practice location

2805 J St Ste 100
Sacramento, CA 95816-4307

Mailing address

2805 J St Ste 100
Sacramento, CA 95816-4307
Phone (916) 492-1828

Other identifiers 1

IdentifierTypeStateIssuer
1760409742MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081016000114 CA Practitioner - Dermatology 6901964196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
73 of 100Reported as group
Quality
100
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C53335CAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J Fazio, MD Inc Mohs-Micrographic Surgery CurrentSince Aug 1, 2011 Accepting new patients

Locations

2805 J St
Ste 100
Sacramento, CA 95816
Phone (916) 492-1828

1525 Response Rd
Sacramento, CA 95815
Phone (916) 492-1828

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1760409742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 J ST STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164307",
            "telephone_number": "916-492-1828",
            "fax_number": "916-492-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 J ST STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164307",
            "telephone_number": "916-492-1828",
            "fax_number": "916-492-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUKER",
        "first_name": "SUMMER",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "C53335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760409742",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.