BRAD NANIGIAN (MD) – Student in an Organized Health Care Education/Training Program, NPI 1205807484

BRAD NANIGIAN (MD) is a healthcare provider. based in Sacramento, California. specializing in PLASTIC AND RECONSTRUCTIVE SURGERY. They hold the professional credentials MD. The NPI Number for BRAD NANIGIAN (MD) is 1205807484

Main info

Male
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
BRAD NANIGIAN (MD)
NPI
1205807484
Phone
(916) 456-5676
Address
5232 U ST
Enumeration Date
27 January 2006
Last Update Date
11 February 2022

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2094762000
Graduation Year
2000 (26 years ago)
PAC ID
1759382534
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20070122000365
Address ID
CA952103377ST7373XLANE300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:20State licenses:0Other namesUpdated within 12 months

803 PLASTIC AND RECONSTRUCTIVE SURGERY in CA

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Provider Addresses for BRAD NANIGIAN (MD)

  • 5232, U Street, Elmhurst, Oak Park, Sacramento, Sacramento County, California, 95817, United States

    SACRAMENTO, CA 958171646

    Phone: (916) 456-5676

    Type: Mailing

  • 7373, West Lane, Stockton, San Joaquin County, California, 95210, United States

    SURGERY CLINIC

    STOCKTON, CA 952103377

    Phone: (209) 476-2120

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-01-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070122000365IPlastic And Reconstructive SurgeryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95817)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for BRAD NANIGIAN (MD)?
BRAD NANIGIAN (MD) — NPI 1205807484 — is the standard way to identify this listing.
Is BRAD NANIGIAN (MD) still practicing?
BRAD NANIGIAN (MD) is currently listed as active in the public NPI registry.
What is BRAD NANIGIAN (MD)'s specialty?
The listing groups BRAD NANIGIAN (MD) with Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
Does BRAD NANIGIAN (MD) list a practice location?
Patients near Sacramento, California may find BRAD NANIGIAN (MD) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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