NPIMap

Individual provider Active NPI

Manuel Ramon Sacapano, M.D.

  • General Practice Physician
  • Hawaiian Gardens, CA
National Provider Identifier
1851315980
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A77588 Issued in CA
Practice address
21530 Pioneer Blvd
Hawaiian Gardens, CA 90716-2608
Phone
(714) 522-2001
Fax
(714) 522-7503
NPI assigned
Jul 26, 2006
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A77588 CA Primary

Addresses

Primary practice location

21530 Pioneer Blvd
Hawaiian Gardens, CA 90716-2608

Mailing address

12376 Primrose Ave
Whittier, CA 90602-1094
Phone (818) 450-4649

Other practice location 1

1535 W Merced Ave Ste 202
West Covina, CA 91790-3404
Phone (818) 450-4649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061128000623 CA Practitioner - Emergency MedicinePractitioner - General Practice 6103824214 Reassigns benefits to 2 organizations
Practice locations: Hawaiian Gardents, CA

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21530 S Pioneer Blvd
Hawaiian Gardents, CA 90716-2608
Phone (714) 522-2001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77588CAMDMarriage & Family Therapist
A77588CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Physicians Medical Allied Group Inc CurrentSince Aug 31, 2023 Accepting new patients
Global Mobile Medical Alliances, Inc. CurrentSince Aug 31, 2023 Accepting new patients
Global Integrated Medical Group, Inc. CurrentSince Aug 31, 2023 Accepting new patients
Global Medical GRP Inc CurrentSince Aug 31, 2023 Accepting new patients
US Dept of HHS Past Accepting new patients
Eternal Life Hospice, Inc. PastSince Jun 8, 2020 Accepting new patients
Premier Emergency Physicians of California Medical Group PC PastSince Nov 1, 2007 Accepting new patients
Last Frontier Healthcare District PastSince Nov 21, 2017 Accepting new patients
Sierra Rural Physicians, Inc. Past Accepting new patients
California Hospitalists Emergency Physicians Medical Group Inc Past Accepting new patients

Locations

1535 W Merced Ave
Ste 201
West Covina, CA 91790
Phone (626) 337-6246

1535 W Merced Ave
Ste 202
West Covina, CA 91790
Phone (626) 337-6246

818 W Cameron Ave
West Covina, CA 91790
Phone (626) 264-8847

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lynwood Post Acute Care CenterLynwood, CA, CCN 056415 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 28, 2019
Mar 28, 2019
Westlake Village Hospice, Inc.Westlake Village, CA, CCN 921557 Hospice Corporate Director Oct 18, 2019
Eternal Life Hospice IncWestlake Village, CA, CCN B31709 Hospice Corporate Director Jun 8, 2020

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1851315980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12376 PRIMROSE AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021094",
            "telephone_number": "818-450-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21530 PIONEER BLVD",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907162608",
            "telephone_number": "714-522-2001",
            "fax_number": "714-522-7503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1535 W Merced Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917903404",
            "country_code": "US",
            "telephone_number": "818-450-4649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SACAPANO",
        "first_name": "MANUEL",
        "middle_name": "RAMON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A77588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawaiian Gardens, CA

Sources for this page

Verify at the official NPI Registry.