Individual provider Active NPI

Marissa Gomez Vadi, M.D.

  • Anesthesiology Physician
  • Sacramento, CA
National Provider Identifier
1811137144
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A106030 Issued in CA
Practice address
Patient Support Services BLDG
4150 V Street, Suite 1200
Sacramento, CA 95817
Phone
(916) 734-5028
Fax
(916) 734-7980
NPI assigned
Feb 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X A106030 CA
Anesthesiology Physician 207L00000X A106030 CA Primary

Addresses

Primary practice location

Patient Support Services BLDG
4150 V Street, Suite 1200
Sacramento, CA 95817

Mailing address

Patient Support Services BLDG
4150 V Street, Suite 1200
Sacramento, CA 95817
Phone (916) 734-5028

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
I20120906000315 CA Practitioner - Anesthesiology 5991952467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Feb 1, 2018 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of Ca Anesthesiology CurrentSince Feb 1, 2018 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Loma Linda Univ Anesthesiology Medical Group Inc Anesthesiology Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

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

2315 Stockton Blvd
Ste 1200
Sacramento, CA 95817
Phone (916) 734-5394

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1811137144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PATIENT SUPPORT SERVICES BLDG",
            "address_2": "4150 V STREET, SUITE 1200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-5028",
            "fax_number": "916-734-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PATIENT SUPPORT SERVICES BLDG",
            "address_2": "4150 V STREET, SUITE 1200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-5028",
            "fax_number": "916-734-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADI",
        "first_name": "MARISSA",
        "middle_name": "GOMEZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-26",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CA",
            "license": "A106030",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A106030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.