NPIMap

Individual provider Active NPI

Randall P. Nacamuli, MD

  • Plastic Surgery Physician
  • Santa Cruz, CA
National Provider Identifier
1902942535
Registry record updated Aug 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A72631 Issued in CA
Practice address
1595 Soquel Dr
Suite 310
Santa Cruz, CA 95065-1719
Phone
(831) 464-8880
Fax
(831) 464-8881
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A72631 CA Primary

Addresses

Primary practice location

1595 Soquel Dr
Suite 310
Santa Cruz, CA 95065-1719

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

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
I20050317000349 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 5395790877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Temple University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1595 Soquel Dr
Santa Cruz, CA 95065-1724

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue164
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72631CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Aug 1, 2007 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Aug 1, 2007 Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Microsurgical Transplantation Research Foundation Past Accepting new patients
Community Memorial Health System Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

1595 Soquel Dr
Ste 400
Santa Cruz, CA 95065
Phone (831) 475-1111

1595 Soquel Dr
Ste 310
Santa Cruz, CA 95065
Phone (831) 464-8880

Organizations & group practices 8

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 2

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692489600000",
    "number": "1902942535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 SOQUEL DR",
            "address_2": "SUITE 310",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651719",
            "telephone_number": "831-464-8880",
            "fax_number": "831-464-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACAMULI",
        "first_name": "RANDALL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-08-20",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A72631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.