Individual provider Active NPI

Bobbi S Underhill, DO

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1922107564
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A7564 Issued in CA
Practice address
3701 J St
Suite 201
Sacramento, CA 95816-5562
Phone
(855) 354-2242
Fax
(916) 457-6227
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20A7564 CA Primary

Addresses

Primary practice location

3701 J St
Suite 201
Sacramento, CA 95816-5562

Mailing address

3701 J St
Suite 201
Sacramento, CA 95816-5562
Phone (855) 354-2242

Other identifiers 3

IdentifierTypeStateIssuer
P01283856/DS9933OtherCARAILROAD MEDICARE
P01453324-DV5277OtherCARAILROAD MEDICARE
020A75640OtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200604000057 TX Practitioner - Pediatric MedicinePractitioner - Internal Medicine 1456313634 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7564CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Apr 22, 2020 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Apr 22, 2020 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. Current Accepting new patients
Molina Healthcare of California Past Accepting new patients
Rideout Memorial Hospital Past Accepting new patients
Hanh Truong, M.D., PA Past Accepting new patients
Molina Healthcare of California Past Accepting new patients

Locations

11555 Potrero Rd
#1-2
Banning, CA 92220
Phone (909) 849-4761

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bobbi.underhill.p1@direct.cmcentersinc.nextgenshare.com
  • Direct secure messaging: bunderhill373571@direct.ochin.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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1922107564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 J ST",
            "address_2": "SUITE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165562",
            "telephone_number": "855-354-2242",
            "fax_number": "916-457-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 J ST",
            "address_2": "SUITE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165562",
            "telephone_number": "855-354-2242",
            "fax_number": "916-457-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERHILL",
        "first_name": "BOBBI",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A7564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01283856/DS9933",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01453324-DV5277",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "020A75640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.