Individual provider Active NPI

Andrew Nuibe, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Sacramento, CA
National Provider Identifier
1821225582
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2516 Stockton Boulevard
Dept. of Pediatrics
Sacramento, CA 95817
Phone
(916) 734-3112
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2516 Stockton Boulevard
Dept. of Pediatrics
Sacramento, CA 95817

Mailing address

2521 Stockton Blvd
Ste 2200
Sacramento, CA 95817
Phone (916) 734-3112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151202002050 VA Practitioner - Pediatric MedicinePractitioner - Infectious Disease 5799917498 Reassigns benefits to 2 organizations
I20160322000801 DC Practitioner - Pediatric MedicinePractitioner - Infectious Disease 5799917498 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Apr 28, 2024 Accepting new patients
Inova Health Care Services CurrentSince Apr 28, 2024 Accepting new patients
Pediatric Specialists of Virginia, LLC CurrentSince Sep 16, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2521 Stockton Blvd
Ste 2200
Sacramento, CA 95817
Phone (916) 734-1180

3023 Hamaker Ct
Ste 600
Fairfax, VA 22031
Phone (703) 839-8733

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

14904 Richmond Hwy
Woodbridge, VA 22191
Phone (703) 492-6660

Interoperability endpoints

  • Direct secure messaging: anuibe177126@soc.inova.org

Organizations & group practices 4

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1821225582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 STOCKTON BLVD",
            "address_2": "STE 2200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BOULEVARD",
            "address_2": "DEPT. OF PEDIATRICS",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUIBE",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.