Individual provider Active NPI

Tomas Vasiliauskas, M.D.

  • Cardiovascular Disease Physician
  • Santa Rosa, CA
National Provider Identifier
1073612529
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
C51710 Issued in CA
Practice address
500 Doyle Park Dr
Suite G05
Santa Rosa, CA 95405-4558
Phone
(707) 576-7100
Fax
(707) 576-8482
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X C51710 CA Primary

Addresses

Primary practice location

500 Doyle Park Dr
Suite G05
Santa Rosa, CA 95405-4558

Mailing address

500 Doyle Park Dr
Suite G05
Santa Rosa, CA 95405-4558
Phone (707) 576-7100

Other identifiers 1

IdentifierTypeStateIssuer
C51710OtherCACALIFORNIA STATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tvasiliauskas1658418@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050207000473 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Nuclear Medicine 7214988336 Reassigns benefits to 2 organizations
Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Nuclear Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

1375 University St
Healdsburg, CA 95448-3382
Phone (707) 547-5437

141 Lynch Creek Way
Suite C
Petaluma, CA 94954-2390
Phone (707) 763-0802

200 W Ctr St Promenade
Anaheim, CA 92805-3960

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-8121

2710 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 267-2060

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

6580 Hembree LN
Suite 270
Windsor, CA 95492-6885
Phone (707) 838-2044

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C51710CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Health Northern California, LLC CurrentSince Mar 15, 2021 Accepting new patients
Providence Medical Foundation Current Accepting new patients
St. Joseph Health Northern California, LLC CurrentSince Mar 15, 2021 Accepting new patients
Providence Medical Foundation CurrentSince Apr 1, 2017 Accepting new patients
Providence Medical Foundation CurrentSince Apr 1, 2017 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

3300 Renner Dr
Fortuna, CA 95540
Phone (707) 725-3361

1375 University St
Healdsburg, CA 95448
Phone (707) 385-2025

1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

500 Doyle Park Dr
Ste G05
Santa Rosa, CA 95405
Phone (707) 576-7100

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste G04
Santa Rosa, CA 95405
Phone (707) 303-8360

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1073612529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE G05",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-576-7100",
            "fax_number": "707-576-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE G05",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-576-7100",
            "fax_number": "707-576-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILIAUSKAS",
        "first_name": "TOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C51710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE LICENSE",
            "identifier": "C51710",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tvasiliauskas1658418@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "500 Doyle Park Dr",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.