Individual provider Active NPI

Sapna Suresh, OTR

  • Physician Assistant
  • Laguna Hills, CA
National Provider Identifier
1992929905
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61756 Issued in CA
Practice address
27001 Moulton Pkwy Ste A102
Laguna Hills, CA 92656-3626
Phone
(959) 600-1907
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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 PA61756 CA Primary

Addresses

Primary practice location

27001 Moulton Pkwy Ste A102
Laguna Hills, CA 92656-3626

Mailing address

27001 Moulton Pkwy Ste A102
Laguna Hills, CA 92656-3626
Phone (949) 600-1907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170113002548 CA Practitioner - Occupational Therapist in Private Practice 6103108709 Reassigns benefits to 1 organization
I20230126002606 CA Practitioner - Physician Assistant 6103108709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

2100 S Euclid St
Suite 102
Anaheim, CA 92802-4572
Phone (714) 644-9100

235 E 17TH St
Costa Mesa, CA 92627-3831
Phone (949) 688-2010

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

5101 Lakewood Blvd
Lakewood, CA 90712-2413
Phone (562) 800-3883

8135 N Painter Ave
Suite 104
Whittier, CA 90602-3164
Phone (562) 758-2345

831 S State College Blvd
Anaheim, CA 92806-4613
Phone (714) 533-2273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61756CAMDPharmacist
PA61756CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Therapy Associates CurrentSince Dec 21, 2016 Accepting new patients
Nellie Gail Urgent Care PastSince May 7, 2023 Accepting new patients

Locations

15775 Laguna Canyon Rd
Ste 110
Irvine, CA 92618
Phone (714) 500-8388

101 Pacifica
Ste 270
Irvine, CA 92618
Phone (949) 333-3833

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1992929905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27001 MOULTON PKWY STE A102",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926563626",
            "telephone_number": "949-600-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27001 MOULTON PKWY STE A102",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926563626",
            "telephone_number": "959-600-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURESH",
        "first_name": "SAPNA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.