Carly Jane-Hustrei Haaland, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA53947 Issued in CA

Practice address

3814 Auburn Blvd Ste 72
Sacramento, CA 95821-2123

Phone

(916) 426-1902

Fax

(916) 647-0156

NPI assigned

Oct 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carly Burkland Former name

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

Specialty

Physician Assistant

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BDHFAA
• Direct secure messaging: chustrei579714@hisp.ehr.sutterhealth.org

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.

• Sutter Valley Medical Foundation

  dba Sutter Gould Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment Care Compare group
• Sutter Valley Medical Foundation

  dba Sutter Regional Medical Foundation

  • Multi-Specialty Clinic/Center
  • Fairfield, CA
  • NPI 1184859894

  Physician Assistant

  NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Capitol Endocrinology Inc

  • Internal Medicine Physician
  • Folsom, CA
  • NPI 1588835375
  NPD (past)
• Sutter North Medical Foundation

  dba Sutter North Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1144251521
  NPD (past)

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1922550821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 AUBURN BLVD STE 72",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958212123",
            "telephone_number": "916-426-1902",
            "fax_number": "916-647-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 AUBURN BLVD STE 72",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958212123",
            "telephone_number": "916-426-1902",
            "fax_number": "916-647-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAALAND",
        "first_name": "CARLY",
        "middle_name": "JANE-HUSTREI",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA53947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "BURKLAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Ha
• Thanh Ha, FNP
• Arlene Limongco Haag, ATC
• Darrow E Haagensen Jr., MD PHD
• Nicholas Haake
• Ann F Haas, M.D.
• Chris Haas
• Janet Martire Haas, LCSW
• Kelly Beth Haas, MD
• Carolyn E. Haase, MD

• Physician Assistant in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.