Individual provider Active NPI

Robert K Omogrosso, DO

  • Family Medicine Physician
  • Grass Valley, CA
National Provider Identifier
1902253610
Registry record updated Jun 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A15941 Issued in CA
Practice address
155 Glasson Way
Grass Valley, CA 95945-5723
Phone
(530) 274-6761
Fax
(530) 274-6175
NPI assigned
May 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A15941 CA Primary

Addresses

Primary practice location

155 Glasson Way
Grass Valley, CA 95945-5723

Mailing address

155 Glasson Way
Grass Valley, CA 95945-5723
Phone (530) 274-6761

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
I20191009000445 CA Practitioner - Family Practice 8022301035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A15941CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists of California, PC Family Medicine CurrentSince Aug 7, 2019 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Oct 5, 2021 Accepting new patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Oct 5, 2021 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

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

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Interoperability endpoints

  • Direct secure messaging: romogrosso414324@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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 5

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": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624665600000",
    "number": "1902253610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455723",
            "telephone_number": "530-274-6761",
            "fax_number": "530-274-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455723",
            "telephone_number": "530-274-6761",
            "fax_number": "530-274-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOGROSSO",
        "first_name": "ROBERT",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A15941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.