Individual provider Active NPI

Ronaldo Flores, P.A.

  • Medical Physician Assistant
  • Sacramento, CA
National Provider Identifier
1942617089
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
22209 Issued in CA
Practice address
2025 Morse Ave
Sacramento, CA 95825-2115
Phone
(916) 973-5490
NPI assigned
Jul 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 22209 CA Primary

Addresses

Primary practice location

2025 Morse Ave
Sacramento, CA 95825-2115

Mailing address

1528 Eureka Rd
Ste 103
Roseville, CA 95661-3047
Phone (916) 461-4543

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
I20151026001691 CA Practitioner - Physician Assistant 2769791136 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
22209CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spine & Nerve Diagnostic Center CurrentSince Jan 29, 2019 Accepting new patients
Spine & Nerve Diagnostic Center CurrentSince Jan 29, 2019 Accepting new patients
Integrative Sports and Spine Inc Past Accepting new patients

Locations

1528 Eureka Rd
Ste 103
Roseville, CA 95661
Phone (916) 772-5325

Interoperability endpoints

  • Direct secure messaging: rflores346507@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1942617089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 EUREKA RD",
            "address_2": "STE 103",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613047",
            "telephone_number": "916-461-4543",
            "fax_number": "916-771-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 MORSE AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252115",
            "telephone_number": "916-973-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "RONALDO",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-22",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "22209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.