Active NPI
Bryan Kolozsi, D.C.
- Sports Physician Chiropractor
- Menlo Park, CA
National Provider Identifier
1073696506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- DC-25732
- Practice address
- 885 Oak Grove Ave Ste 102-5
Menlo Park, CA 94025-4400 - Phone
- (650) 322-6080
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | DC-25732 | CA | Primary |
Addresses
Primary practice location
885 Oak Grove Ave Ste 102-5
Menlo Park, CA 94025-4400
Mailing address
885 Oak Grove Ave Ste 102-5
Menlo Park, CA 94025-4400
Phone (650) 322-6080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121005000275 | CA | Practitioner - Chiropractic | 2668621798 | Practice locations: Menlo Park, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC-25732 | CA | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677024000000",
"number": "1073696506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "885 OAK GROVE AVE STE 102-5",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254400",
"telephone_number": "650-322-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "885 OAK GROVE AVE STE 102-5",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254400",
"telephone_number": "650-322-6080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLOZSI",
"first_name": "BRYAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2023-02-22",
"certification_date": "2023-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "CA",
"license": "DC-25732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menlo Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.