Individual provider Active NPI

Rupinderjit Kaur Samra, NP

  • Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1912139114
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
17660 Issued in CA
Practice address
4150 V St Ste G400
Sacramento, CA 95817-1460
Phone
(916) 734-8464
Fax
(916) 734-7953
NPI assigned
Aug 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 629802 CA
Clinical Nurse Specialist 364S00000X 3026 CA
Nurse Practitioner 363L00000X 17660 CA Primary

Addresses

Primary practice location

4150 V St Ste G400
Sacramento, CA 95817-1460

Mailing address

4150 V St Ste G400
Sacramento, CA 95817-1460
Phone (916) 734-8464

Other names 1

  • Rupinderjit K Samra Professional name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201015002870 CA Practitioner - Nurse Practitioner 3476832981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone (916) 734-2680

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
629802CAMDRegistered Nurse
17660CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Nov 29, 2021 Accepting new patients
Regents of the Univ of Ca CurrentSince Nov 29, 2021 Accepting new patients
Natomas Family Practice CurrentSince Sep 24, 2020 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 400
Sacramento, CA 95817
Phone (916) 734-1482

2410 Del Paso Rd
Sacramento, CA 95834
Phone (916) 928-0856

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

Organizations & group practices 5

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 1

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": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1912139114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST STE G400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-8464",
            "fax_number": "916-734-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V ST STE G400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-8464",
            "fax_number": "916-734-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMRA",
        "first_name": "RUPINDERJIT",
        "middle_name": "KAUR",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "629802",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "3026",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "17660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUPINDERJIT",
            "last_name": "SAMRA",
            "middle_name": "K",
            "credential": "NURSE PRACTITIONER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.