BLOSSOM RIDGE MEDICAL, INC.
NPI 1679117972
Clinic/Center - Community Health in Sacramento, CA
About Blossom Ridge Medical, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLOSSOM RIDGE MEDICAL, INC. (NPI 1679117972) is a healthcare organization registered as a community health in Sacramento, California and active in the NPI registry since October 2019. The organization lists Gerald Agustin, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Blossom Ridge Medical, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
21Medicare enrollment records show 21 clinicians reassign Medicare billing to Blossom Ridge Medical, Inc., which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 8
Nearest to this location (20)
See all 21Los Angeles, CA 90041
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Blossom Ridge Medical, Inc.'s NPI number?
The NPI number for Blossom Ridge Medical, Inc. is 1679117972. It was assigned to this organization in the NPPES registry on October 30, 2019.
Where is Blossom Ridge Medical, Inc. located?
Blossom Ridge Medical, Inc. is located at 2554 Millcreek Dr, Sacramento, CA 95833. The listed phone number is (800) 991-6147.
What is Blossom Ridge Medical, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.
Is Blossom Ridge Medical, Inc. enrolled in Medicare?
Yes. Blossom Ridge Medical, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Blossom Ridge Medical, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 21 clinicians in 8 Medicare specialties reassign their Medicare billing to Blossom Ridge Medical, Inc.. 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 (12), Family Practice (2) and Nephrology (2). Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Blossom Ridge Medical, Inc. was last updated on March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.
# Blossom Ridge Medical, Inc. · NPI 1679117972
Community Health organization in Sacramento, California. Organization record, active in the CMS NPPES registry since October 30, 2019.
## Identity
- **NPI:** 1679117972 (Entity type: Organization)
- **Enumerated:** October 30, 2019
- **Primary specialty:** Clinic/Center - Community Health · taxonomy 261QC1500X
- **Organization subpart:** No
- **Authorized official:** Gerald Agustin, CEO
## Practice location
- **Address:** 2554 MILLCREEK DR, Sacramento, CA 95833-3678
- **Phone:** (800) 991-6147 · **Fax:** (916) 382-7683
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 21 clinicians in 8 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (12), Family Practice (2), Nephrology (2); 6 practice within 10 miles; [full list](https://npiprofile.com/npi/1679117972/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 23, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1679117972) · Data from the CMS NPPES public registry.