R Mitchell Hiserote, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

20A7465 Issued in CA

Practice address

648 McGinnis Cir
Cotati, CA 94931-7718

Phone

(559) 999-8647

NPI assigned

May 9, 2007

Last updated

Feb 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1053525113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 MCGINNIS CIR",
            "city": "COTATI",
            "state": "CA",
            "postal_code": "949317718",
            "telephone_number": "559-999-8647",
            "fax_number": "707-824-8766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 MCGINNIS CIR",
            "city": "COTATI",
            "state": "CA",
            "postal_code": "949317718",
            "telephone_number": "559-999-8647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISEROTE",
        "first_name": "R",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": "20A7465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ida Marie Hallgren-Luke, D.C.
• Wesley Joseph Hamper, LMFT
• Faith Harville-Polk
• Wendy Lee Haynes, PT
• Katheen R. Haynie, CMY
• Donna Susan Housel
• Katie B Hulett
• Kayla Huntington
• Randelle Jansen, CMT
• Lori Ann Jespersen, PSY.D

• Neuromusculoskeletal Medicine & OMM Physician in Cotati, CA
• Providers in Cotati, CA by specialty
• Neuromusculoskeletal Medicine & OMM Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.