Organization Active NPI

Prestige Bariatric and Surgical Specialists Inc

  • Surgery Physician
  • Sacramento, CA
National Provider Identifier
1891182044
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A106886 Issued in CA
Legal business name
PRESTIGE BARIATRIC AND SURGICAL SPECIALISTS INC
Practice address
7551 Timberlake Way Ste 230
Sacramento, CA 95823-5422
Phone
(916) 347-3630
Fax
(916) 347-3632
NPI assigned
Apr 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Hsinju Ruby GatschetNPI 1871753731
Title
MD
Phone
(559) 285-1012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X A106886 CA Primary

Addresses

Primary practice location

7551 Timberlake Way Ste 230
Sacramento, CA 95823-5422

Mailing address

9337 Feather Falls Way
Elk Grove, CA 95624-3980

Other practice location 1

8715 Center Pkwy
Sacramento, CA 95823-7921
Phone (559) 285-1012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150805007642 CA Part B Supplier - Clinic/Group Practice 0648584581 Receives reassigned benefits from 1 practitioner
Practice locations: Sacramento, CA

National Provider Directory

National Provider Directory
Tax ID family
Prestige Bariatric and Surgical Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1745 W Kettleman Ln
Ste D
Lodi, CA 95242
Phone (209) 333-7600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1891182044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9337 FEATHER FALLS WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956243980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7551 TIMBERLAKE WAY STE 230",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235422",
            "telephone_number": "916-347-3630",
            "fax_number": "916-347-3632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8715 Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958237921",
            "country_code": "US",
            "telephone_number": "559-285-1012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRESTIGE BARIATRIC AND SURGICAL SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-24",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "GATSCHET",
        "authorized_official_first_name": "HSINJU",
        "authorized_official_middle_name": "RUBY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "559-285-1012"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A106886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.