Active NPI
Theodore Hoffman, M.D.
- Child & Adolescent Psychiatry Physician
- Sacramento, CA
National Provider Identifier
1982762787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- A24849
- Practice address
- 1792 Tribute Rd
Suite 350
Sacramento, CA 95815-4305 - Phone
- (916) 924-6400
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | A24849 | CA | Primary |
Addresses
Primary practice location
1792 Tribute Rd
Suite 350
Sacramento, CA 95815-4305
Mailing address
1792 Tribute Rd
Suite 350
Sacramento, CA 95815-4305
Phone (916) 924-6400
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000810837378 | Other | CA | PHCS |
| 90099280 | Other | CA | PACIFICARE |
| 00A248490 | Medicaid | CA | |
| 24101 | Other | CA | INTERPLAN |
| A24849 | Other | CA | BLUE CROSS |
| 5717779 | Other | CA | FIRST HEALTH |
| 3835 | Other | CA | FIRST HEALTH |
| 426748 | Other | CA | GREAT WEST |
| MCMG379500 | Other | CA | WESTERN HEALTH ADVANTAGE |
| 5180106 | Other | CA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A24849 | CA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329436800000",
"number": "1982762787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1792 TRIBUTE RD",
"address_2": "SUITE 350",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958154305",
"telephone_number": "916-924-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1792 TRIBUTE RD",
"address_2": "SUITE 350",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958154305",
"telephone_number": "916-924-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOFFMAN",
"first_name": "THEODORE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2012-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "A24849",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "000810837378",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE",
"identifier": "90099280",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A248490",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERPLAN",
"identifier": "24101",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "A24849",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "5717779",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "3835",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "426748",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WESTERN HEALTH ADVANTAGE",
"identifier": "MCMG379500",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5180106",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.