Individual provider Active NPI

Altaf Jan, M.D.

  • Gastroenterology Physician
  • Sacramento, CA
National Provider Identifier
1922072404
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
24321 Issued in AZ
Practice address
2725 Capitol Ave
Suite 300
Sacramento, CA 95816-6004
Phone
(916) 262-9370
Fax
(916) 262-9375
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 24321 AZ Primary

Addresses

Primary practice location

2725 Capitol Ave
Suite 300
Sacramento, CA 95816-6004

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (855) 771-0335

Other identifiers 1

IdentifierTypeStateIssuer
367765MedicaidAZ

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
I20071215000258 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 0840225702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

5765 Greenback LN
Sacramento, CA 95841-2013
Phone (916) 865-1040

Hospital & facility affiliations

  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy226
Upper gastrointestinal (GI) endoscopy for acid reflux175

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24321AZMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Nov 5, 2007 Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Bullhead City Hospital Corporation Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Kingman Healthcare, Inc Past Accepting new patients
Tri State Gastroenterology, P.C. Gastroenterology PastSince Jan 1, 1990 Accepting new patients

Locations

2725 Capitol Ave
Dept 300
Sacramento, CA 95816
Phone (916) 262-9370

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

2725 Capitol Ave
Sacramento, CA 95816
Phone (916) 262-9370

Interoperability endpoints

  • Direct secure messaging: ajanmd11696@hisp.ehr.sutterhealth.org

Organizations & group practices 7

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1922072404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "855-771-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 CAPITOL AVE",
            "address_2": "SUITE 300",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958166004",
            "telephone_number": "916-262-9370",
            "fax_number": "916-262-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAN",
        "first_name": "ALTAF",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "24321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "367765",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.