Dwain W Rickertsen (NPI# 1619165925, PAC ID# 4981689395) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1619165925 |
| PAC ID by PECOS | 4981689395 |
| Professional Enrollment ID | I20040621000994 |
| Full Name | Dwain W Rickertsen |
| Organization Legal Name | MACT HEALTH BOARD INC. |
| Address |
12140 New York Ranch Rd Jackson CA 95642-9407 |
| Phone Number | 2092572400 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1985 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 8325936974 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050014 | SUTTER AMADOR HOSPITAL |
| 051332 | MARK TWAIN MEDICAL CENTER |
| 050108 | SUTTER MEDICAL CENTER, SACRAMENTO |
| Address | Phone | Organization |
|---|---|---|
| 12140 New York Ranch Rd, Jackson, CA 95642-9407 | 2092572400 | MACT HEALTH BOARD INC. |
| Organization Legal Name | MACT HEALTH BOARD INC. |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin Nathan Cornwell | Optometry | Mact Health Board Inc. | 1113a Hwy 49, San Andreas, CA 95249-9583 |
| Alton J Smalley | Podiatry | Mact Health Board Inc. | 12140 New York Ranch Rd, Jackson, CA 95642-9407 |
| Elisabeth A Siegler | Orthopedic Surgery | Mact Health Board Inc. | 1113 Hwy 49, San Andreas, CA 95249-9583 |
| Daljit Kaur Bagha | Family Medicine | Mact Health Board Inc. | 13975 Mono Way, Suite G, Sonora, CA 95370-2824 |
| Ravinder Kadevari | Family Medicine | Mact Health Board Inc. | 5192 Hospital Rd, Mariposa, CA 95338-9524 |
| Alejandro Abarca | Clinical Social Worker | Mact Health Board Inc. | 13975 Mono Way, Suite G, Sonora, CA 95370-2824 |
| Janet Louise Black | Clinical Social Worker | Mact Health Board Inc. | 13975 Mono Way, Suite G, Sonora, CA 95370-2824 |
| Mikla N Derlet | Pediatric Medicine | Mact Health Board Inc. | 13975 Mono Way, Suite G, Sonora, CA 95370-2824 |
| Maureen Patricia Mooney-michels | Registered Dietitian Or Nutrition Professional | Mact Health Board Inc. | 12140 New York Ranch Rd, Jackson, CA 95642-9407 |
| Street Address |
12140 NEW YORK RANCH RD |
| City | JACKSON |
| State | CA |
| Zip | 95642-9407 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alton J Smalley | Podiatry | Mact Health Board Inc. | 12140 New York Ranch Rd, Jackson, CA 95642-9407 |
| Philip Morris Bach | Cardiovascular Disease (cardiology) | Sacramento Heart and Vascular Medical | 12140 New York Ranch Rd, Jackson, CA 95642-9407 |
| Michael D Fugit | Interventional Cardiology | Sacramento Heart and Vascular Medical | 12140 New York Ranch Rd, Jackson, CA 95642-9407 |
| Maureen Patricia Mooney-michels | Registered Dietitian Or Nutrition Professional | Mact Health Board Inc. | 12140 New York Ranch Rd, Jackson, CA 95642-9407 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Geraldine T Oshea | Internal Medicine | 235 New York Ranch Rd B, Foothills Womens Cnt, Jackson, CA 95642-2147 | |
| Terrence C Turpen | Physician Assistant | 223 New York Ranch Rd, Jackson, CA 95642-2147 | |
| Anant K Lodhia | Internal Medicine | 223 New York Ranch Rd, Jackson, CA 95642-2147 | |
| Nichole Michelle Renschler | Physician Assistant | Sutter Valley Medical Foundation | 815 Court St, Jackson, CA 95642-2154 |
| John Chin | Cardiac Surgery | Sutter Valley Medical Foundation | 815 Court St, Jackson, CA 95642-2154 |
| Kelly E Pate | Physician Assistant | Sutter Valley Medical Foundation | 815 Court St, Jackson, CA 95642-2154 |
| Neel Kg Shah | Internal Medicine | Sutter Valley Medical Foundation | 815 Court St, Jackson, CA 95642-2154 |
| Anita Bai Xue | Anesthesiology | Sutter Valley Medical Foundation | 815 Court St, Jackson, CA 95642-2154 |
| Marianne E La Pointe | Physician Assistant | Sutter Valley Medical Foundation | 815 Court St, Jackson, CA 95642-2154 |
| Anastasia L Collins | Family Medicine | Sutter Valley Medical Foundation | 815 Court St, Jackson, CA 95642-2154 |
| Find all physicians in zip 95642 | |||
| City | JACKSON |
| Zip Code | 95642 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | JACKSON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Dwain W Rickertsen.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.