NPIMap

Individual provider Active NPI

Nicklesh Thakur, D.O.

  • Neurological Surgery Physician
  • Sacramento, CA
National Provider Identifier
1801917554
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
20A9158 Issued in CA
Practice address
2800 L St
Suite 500
Sacramento, CA 95816-5616
Phone
(916) 454-6850
Fax
(916) 454-6852
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 20A9158 CA Primary
Neurology Physician 2084N0400X 20A9158 CA

Addresses

Primary practice location

2800 L St
Suite 500
Sacramento, CA 95816-5616

Mailing address

10470 Old Placerville Rd
#100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050829000874 CA Practitioner - Neurology 8729019740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9158CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Neurology CurrentSince Jun 26, 2007 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: nthakurdo57467@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1801917554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "#100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 L ST",
            "address_2": "SUITE 500",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165616",
            "telephone_number": "916-454-6850",
            "fax_number": "916-454-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKUR",
        "first_name": "NICKLESH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "20A9158",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "20A9158",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.