Individual provider Active NPI

Alicia Agnoli, MD

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1790044303
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
150159 Issued in CA
Practice address
4860 Y St Ste 2320
Sacramento, CA 95817-2307
Phone
(916) 734-3630
Fax
(916) 734-5636
NPI assigned
May 16, 2012
Last updated
Aug 29, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 150159 CA Primary

Addresses

Primary practice location

4860 Y St Ste 2320
Sacramento, CA 95817-2307

Mailing address

4860 Y Street, Suite 2320
Sacramento, CA 95817
Phone (916) 734-3630

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
I20170830003893 CA Practitioner - Family Practice 4981977667 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

4860 Y St
Sacramento, CA 95817-2307
Phone (916) 734-7005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
150159CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca Family Medicine CurrentSince Sep 1, 2017 Accepting new patients
County of Sacramento CurrentSince Jan 1, 2020 Accepting new patients
Regents of the Univ of Ca CurrentSince Sep 1, 2017 Accepting new patients
County of Sacramento CurrentSince Jan 1, 2020 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670

4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670

4600 Broadway
Ste 1100
Sacramento, CA 95820
Phone (916) 874-9670

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 2320
Sacramento, CA 95817
Phone (916) 734-2833

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

Interoperability endpoints

  • Direct secure messaging: aagnoli298729@direct.ochin.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503964800000",
    "number": "1790044303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y STREET, SUITE 2320",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-3630",
            "fax_number": "916-734-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 2320",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-3630",
            "fax_number": "916-734-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNOLI",
        "first_name": "ALICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2017-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "150159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.