Individual provider Active NPI

Emanual Michael Maverakis, M.D.

  • Dermatology Physician
  • Sacramento, CA
National Provider Identifier
1942274592
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A91555 Issued in CA
Practice address
3301 C St
Ste 100
Sacramento, CA 95816-3300
Phone
(916) 734-6371
Fax
(916) 734-6793
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A91555 CA Primary

Addresses

Primary practice location

3301 C St
Ste 100
Sacramento, CA 95816-3300

Mailing address

2416 50TH St
Sacramento, CA 95817-1503
Phone (916) 734-6371

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
I20070911000864 CA Practitioner - Dermatology 3375636053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Harvard Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

3301 C St
Sacramento, CA 95816-3300
Phone (916) 734-6805

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of skin lesions356
Removal or shaving of skin growth11
Skin biopsy54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A91555CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Dermatology CurrentSince Jul 1, 2007 Accepting new patients
Regents of the University of California CurrentSince Oct 1, 2021 Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 1, 2007 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

77 Cadillac Dr
Ste 240
Sacramento, CA 95825
Phone (916) 569-4400

3301 C St
Ste 1300
Sacramento, CA 95816
Phone (916) 734-6111

3301 C St
Sacramento, CA 95816
Phone (916) 734-6111

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

3301 C St
Ste 100
Sacramento, CA 95816
Phone (916) 734-6371

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

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

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942274592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 50TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171503",
            "telephone_number": "916-734-6371",
            "fax_number": "916-734-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 C ST",
            "address_2": "STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163300",
            "telephone_number": "916-734-6371",
            "fax_number": "916-734-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVERAKIS",
        "first_name": "EMANUAL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A91555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.