Individual provider Active NPI

Thomas William Luisetti, MD

  • Anesthesiology Physician
  • Grass Valley, CA
National Provider Identifier
1841247178
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A84365 Issued in CA
Practice address
408 Sierra College Dr
Grass Valley, CA 95945-5089
Phone
(530) 271-2282
Fax
(530) 271-2287
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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 A84365 CA Primary

Addresses

Primary practice location

408 Sierra College Dr
Grass Valley, CA 95945-5089

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (714) 347-1010

Other identifiers 1

IdentifierTypeStateIssuer
00A843650MedicaidCA

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
I20070411000167 CA Practitioner - Anesthesiology 2264537745 Reassigns benefits to 2 organizations
Practice locations: Grass Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

155 Glasson Way
Grass Valley, CA 95945-5723
Phone (530) 274-6000

Hospital & facility affiliations

  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Oct 18, 2018 Accepting new patients
Central Anesthesia Service Exchange Medical Group, Inc. Anesthesiology CurrentSince Jan 1, 2016 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Oct 18, 2018 Accepting new patients
Sacsolano Anesthesia Exchange Medical Group, Inc Anesthesiology Past Accepting new patients

Locations

408 Sierra College Dr
Grass Valley, CA 95945
Phone (530) 271-2282

400 Sierra College Dr
Ste B
Grass Valley, CA 95945
Phone (530) 272-3411

155 Glasson Way
Grass Valley, CA 95945
Phone (530) 274-6000

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2550 Sister Mary Columba Dr
Red Bluff, CA 96080
Phone (530) 529-8000

2175 Rosaline Ave
Ste A
Redding, CA 96001
Phone (530) 225-7400

3315 Watt Ave
Sacramento, CA 95821
Phone (916) 481-0777

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

Organizations & group practices 5

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1841247178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1010",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SIERRA COLLEGE DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455089",
            "telephone_number": "530-271-2282",
            "fax_number": "530-271-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUISETTI",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A84365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A843650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.