Individual provider Active NPI

Sabrina K.G. Tan, M.D.

  • Internal Medicine Physician
  • Woodland, CA
National Provider Identifier
1962608539
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C151878 Issued in CA
Practice address
475 Pioneer Ave
Woodland, CA 95776-4905
Phone
(530) 750-5904
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MDR-5298 HI
Internal Medicine Physician 207R00000X MD60624958 WA
Sports Medicine (Internal Medicine) Physician 207RS0010X MD-15762 HI
Internal Medicine Physician 207R00000X C151878 CA Primary

Addresses

Primary practice location

475 Pioneer Ave
Woodland, CA 95776-4905

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20180606003198 CA Practitioner - Internal MedicinePractitioner - Sports Medicine 0143472589 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Sports Medicine
Education
New York Medical College, 2007
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

475 Pioneer Ave
Woodland, CA 95776-4905

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C151878CAMDInternal Medicine Physician
MDR-5298HIMDInternal Medicine Physician
MD-15762HIMDSports Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Apr 22, 2024 Accepting new patients
Permanente Medical Group, Inc CurrentSince Apr 29, 2018 Accepting new patients
Permanente Medical Group Inc Family Medicine CurrentSince Apr 29, 2018 Accepting new patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Apr 22, 2024 Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2030 Sutter Pl
Ste 1000
Davis, CA 95616
Phone (530) 750-5800

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

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

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

1 Quality Dr
Vacaville, CA 95688
Phone (707) 453-5000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

475 Pioneer Ave
Ste 400
Woodland, CA 95776
Phone (530) 406-5600

Interoperability endpoints

  • Direct secure messaging: stan682804@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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 5

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1962608539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PIONEER AVE",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957764905",
            "telephone_number": "530-750-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "SABRINA",
        "middle_name": "K.G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MDR-5298",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60624958",
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "HI",
            "license": "MD-15762",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C151878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1 Quality Dr",
            "city": "Vacaville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956889494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.