JOHN DIRK COBURN M.D.
NPI 1093078172
Student in an Organized Health Care Education/Training Program in Sacramento, CA
About John Dirk Coburn M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN DIRK COBURN M.D. (NPI 1093078172) is an individual student in an organized health care education/training program in Sacramento, California and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS and is a graduate of Rush Medical College Of Rush University (2012).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
John Dirk Coburn M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show John Coburn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Stockton, CA 95210
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SACRAMENTO, CA 95817
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is John Coburn's NPI number?
The NPI number for John Coburn is 1093078172. It was assigned to this individual provider in the NPPES registry on June 22, 2012.
Where is John Coburn located?
John Coburn practices at 2315 Stockton Blvd # 2100, Sacramento, CA 95817. The listed phone number is (916) 734-8571.
What is John Coburn's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is John Coburn enrolled in Medicare?
Yes. John Coburn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for John Coburn's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Coburn reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Coburn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for John Coburn was last updated on December 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# John Dirk Coburn, M.D. · NPI 1093078172
Student in an Organized Health Care Education/Training Program provider in Sacramento, California. Individual provider, active in the CMS NPPES registry since June 22, 2012.
## Identity
- **NPI:** 1093078172 (Entity type: Individual)
- **Enumerated:** June 22, 2012
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 2315 STOCKTON BLVD # 2100, Sacramento, CA 95817-2201
- **Phone:** (916) 734-8571 · **Fax:** (916) 734-7950
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1548343510, Stockton, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Rush Medical College Of Rush University, class of 2012
## Record status
- **NPPES last updated:** December 15, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1093078172) · Data from the CMS NPPES public registry.