Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Ali Banisad, MD

Individual provider Internal Medicine Physician · NPI 1174016968

Dr. Ali Banisad, MD is a Nephrology in Roseville, California. Qualified in 2009, 17 years ago. Practices with Summit Nephrology Medical Group, Inc, a 10-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and Michigan.

Years since qualifying
17
Licensed in
CA, MI
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

151 N Sunrise Ave Ste 1202
Roseville, CA 95661-2932
Phone: (916) 789-1505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence A202591 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 4301503338 (MI)

Record details

NPI number1174016968
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 7, 2018
Last updated in NPPESJuly 19, 2025
Certification dateJuly 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Summit Nephrology Medical Group, Inc. — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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