NPIMap

Individual provider Active NPI

Andrew Richard De Mar Jr., M.D.

  • Surgery Physician
  • Roseville, CA
National Provider Identifier
1891716023
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G58869 Issued in CA
Practice address
2 Medical Plaza Dr
Suite 275
Roseville, CA 95661-3043
Phone
(916) 797-7534
Fax
(916) 797-4712
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G58869 CA Primary
Surgical Critical Care Physician 2086S0102X G58869 CA
Trauma Surgery Physician 2086S0127X G58869 CA

Addresses

Primary practice location

2 Medical Plaza Dr
Suite 275
Roseville, CA 95661-3043

Mailing address

PO Box 2366
Rocklin, CA 95677-8366
Phone (916) 797-7534

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
I20060214000605 CA Practitioner - General Surgery 1951337633 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Ohio State University College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trauma Medical Group of Roseville IncGroup PAC ID 4880609767, 11 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 781-1382

2 Medical Plaza Dr
Suite 275
Roseville, CA 95661-3051
Phone (916) 797-7534

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58869CAMDGeneral Practice Dentistry
G58869CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma Medical Group of Roseville Inc Surgical Critical Care CurrentSince Mar 22, 1995 Accepting new patients
Andrew R. Demar,Jr,M.D. Inc Surgery CurrentSince Jul 1, 2007 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Dignity Health Past Accepting new patients
Placer Surgical Associates Surgery Past Accepting new patients

Locations

2 Medical Plaza Dr
Ste 275
Roseville, CA 95661
Phone (916) 462-8410

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

Interoperability endpoints

  • Direct secure messaging: ademar25750@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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 4

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239667200000",
    "number": "1891716023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2366",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956778366",
            "telephone_number": "916-797-7534",
            "fax_number": "916-797-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PLAZA DR",
            "address_2": "SUITE 275",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613043",
            "telephone_number": "916-797-7534",
            "fax_number": "916-797-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MAR",
        "first_name": "ANDREW",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2009-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G58869",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "G58869",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "G58869",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.