Individual provider Active NPI

Sage Marie Salacup, PA-C

  • Physician Assistant
  • El Cajon, CA
National Provider Identifier
1972320117
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65088 Issued in CA
Practice address
4921 Dehesa Rd
El Cajon, CA 92019-2929
Phone
(619) 445-0707
Fax
(619) 445-0901
NPI assigned
Sep 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA65088 CA Primary

Addresses

Primary practice location

4921 Dehesa Rd
El Cajon, CA 92019-2929

Mailing address

4921 Dehesa Rd
El Cajon, CA 92019-2929
Phone (619) 445-0707

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
I20260330003595 CA Practitioner - Physician Assistant 1951886753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sycuan Tribal GovernmentGroup PAC ID 3971687799, 5 clinicians

Practice addresses (Care Compare)

5442 Sycuan Rd
El Cajon, CA 92019-1816
Phone (619) 445-0707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA65088CAMDPhysician Assistant

Organizations & group practices 1

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": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1972320117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 DEHESA RD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920192929",
            "telephone_number": "619-445-0707",
            "fax_number": "619-445-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 DEHESA RD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920192929",
            "telephone_number": "619-445-0707",
            "fax_number": "619-445-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALACUP",
        "first_name": "SAGE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-20",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.