Individual provider Active NPI

Gregory Vuksinich, MD

  • Anesthesiology Physician
  • Jackson, CA
National Provider Identifier
1841242559
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
C41691 Issued in CA
Practice address
200 Mission Blvd
Jackson, CA 95642
Phone
(209) 223-7500
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X C41691 CA Primary

Addresses

Primary practice location

200 Mission Blvd
Jackson, CA 95642

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other identifiers 1

IdentifierTypeStateIssuer
00C416910MedicaidCA

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
I20050405000314 CA Practitioner - Anesthesiology 3375439052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northwestern University Feinberg Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amador Anesthesia Medical Group, Inc.Group PAC ID 6305893223, 3 clinicians

Practice addresses (Care Compare)

200 Mission Blvd
Jackson, CA 95642-2564
Phone (209) 223-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C41691CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amador Anesthesia Medical Group, Inc. Anesthesiology CurrentSince Jan 1, 2005 Accepting new patients
Gregory S Vuksinich, M.D., Inc Anesthesiology CurrentSince Jan 29, 1999 Accepting new patients

Locations

223 Clinton Rd
Ste 204
Jackson, CA 95642
Phone (209) 223-5938

Interoperability endpoints

  • Direct secure messaging: gvuksinich113033@hisp.ehr.sutterhealth.org

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.

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1841242559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MISSION BLVD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "95642",
            "telephone_number": "209-223-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUKSINICH",
        "first_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C41691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C416910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, CA

Sources for this page

Verify at the official NPI Registry.