Individual provider Active NPI

Jennifer G. Sarayba, MD

  • Family Medicine Physician
  • Rancho Mirage, CA
National Provider Identifier
1821033788
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A106726 Issued in CA
Practice address
72780 Country Club Dr
BLDG B 205-a
Rancho Mirage, CA 92270-4126
Phone
(760) 779-1721
Fax
(760) 834-3578
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036115473 IL
Family Medicine Physician 207Q00000X A106726 CA Primary

Addresses

Primary practice location

72780 Country Club Dr
BLDG B 205-a
Rancho Mirage, CA 92270-4126

Mailing address

72780 Country Club Dr
BLDG B 205-a
Rancho Mirage, CA 92270-4126
Phone (760) 779-1721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A106726CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nath Medical Corporation Past Accepting new patients
Eisenhower Medical Center Past Accepting new patients

Organizations & group practices 2

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1821033788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR",
            "address_2": "BLDG B 205-A",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704126",
            "telephone_number": "760-779-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR",
            "address_2": "BLDG B 205-A",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704126",
            "telephone_number": "760-779-1721",
            "fax_number": "760-834-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARAYBA",
        "first_name": "JENNIFER",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036115473",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A106726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.