PEACH TREE NORTH SACRAMENTO
NPI 1164886040
Clinic/Center - Federally Qualified Health Center (FQHC) in Sacramento, CA
About Peach Tree North Sacramento NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEACH TREE NORTH SACRAMENTO (NPI 1164886040) is a healthcare organization registered as a federally qualified health center (fqhc) in Sacramento, California and active in the NPI registry since April 2016. The organization holds a CLIA Microscopy certificate valid through November 13, 2027, maintains a secondary practice location in Oroville, and lists Greg S Stone, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Location 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Peach Tree North Sacramento is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
55Medicare enrollment records show 55 clinicians reassign Medicare billing to Peach Tree North Sacramento, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 8 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 13
Nearest to this location (20)
See all 55Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0616752
Peach Tree Sacramento · Sacramento, CAFrequently 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 Peach Tree Healthcare's NPI number?
The NPI number for Peach Tree Healthcare is 1164886040. It was assigned to this organization in the NPPES registry on April 7, 2016. The provider is also known as Peach Tree North Sacramento.
Where is Peach Tree Healthcare located?
Peach Tree Healthcare is located at 3810 Rosin Ct Suite 100, Sacramento, CA 95834. The listed phone number is (530) 741-6245.
What is Peach Tree Healthcare's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Peach Tree Healthcare enrolled in Medicare?
Yes. Peach Tree Healthcare is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Peach Tree Healthcare?
According to the CMS Revalidation Reassignment List (October 2026 release), 55 clinicians in 13 Medicare specialties reassign their Medicare billing to Peach Tree Healthcare. A 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 the clinician's services. The largest specialties are Nurse Practitioner (15), Family Practice (13) and Pediatric Medicine (6). Of these, 5 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Peach Tree Healthcare hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0616752) is associated with this NPI, valid through November 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Peach Tree Healthcare was last updated on May 23, 2022. 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.
# Peach Tree North Sacramento · NPI 1164886040
Federally Qualified Health Center (FQHC) organization in Sacramento, California. Organization record, active in the CMS NPPES registry since April 7, 2016.
## Identity
- **NPI:** 1164886040 (Entity type: Organization)
- **Enumerated:** April 7, 2016
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Peach Tree Healthcare
- **Organization subpart:** No
- **Authorized official:** Greg Stone, CEO
## Practice location
- **Address:** 3810 ROSIN CT, SUITE 100, Sacramento, CA 95834-1656
- **Phone:** (530) 741-6245 · **Fax:** (530) 741-9274
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 55 clinicians in 13 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (15), Family Practice (13), Pediatric Medicine (6); 5 practice at this address and 8 within 10 miles; [full list](https://npiprofile.com/npi/1164886040/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 23, 2022
- **Other identifiers:** Other 751916 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164886040) · Data from the CMS NPPES public registry.