Active Life Wound Center a Professional Medical Corporation
NPI 1396553616 · Family Medicine Physician · Sacramento, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Active Life Wound Center a Professional Medical Corporation is a Family Medicine Physician organization in Sacramento, CA (NPI 1396553616).
Provider details
- NPI number
- 1396553616
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Souza, Compliance Manager(916) 436-3015
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Suppliers
- Wound Care Registered Nurse163WW0000X
Nursing Service Providers
- Dermatology Physician207N00000X
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Active Life Wound Center
Registry dates
- Enumerated
- 2024-12-19
- Last updated
- 2024-12-19
- Certified
- 2024-12-19
Frequently asked questions
- What is Active Life Wound Center a Professional Medical Corporation's NPI number?
- Active Life Wound Center a Professional Medical Corporation's National Provider Identifier (NPI) is 1396553616, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Active Life Wound Center a Professional Medical Corporation?
- Active Life Wound Center a Professional Medical Corporation is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Active Life Wound Center a Professional Medical Corporation located?
- Active Life Wound Center a Professional Medical Corporation's practice location on file with NPPES is 2 Scripps Dr Ste 202, Sacramento, CA 95825-6207.
- What is Active Life Wound Center a Professional Medical Corporation's phone number?
- The practice phone number listed in the NPPES registry for Active Life Wound Center a Professional Medical Corporation is (916) 436-3015.
- Does Active Life Wound Center a Professional Medical Corporation accept Medicare?
- Active Life Wound Center a Professional Medical Corporation is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Active Life Wound Center a Professional Medical Corporation?
- The authorized official listed on Active Life Wound Center a Professional Medical Corporation's NPPES record is Jeffrey Souza, Compliance Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Active Life Wound Center a Professional Medical Corporation's NPI active?
- Yes — Active Life Wound Center a Professional Medical Corporation's NPI (1396553616) is active in the NPPES registry as of the last update on 2024-12-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.