NPIMap

Individual provider Active NPI

Larry David Resneck-Sannes, MD

  • Family Medicine Physician
  • Santa Cruz, CA
National Provider Identifier
1114919784
Registry record updated Mar 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G25952 Issued in CA
Practice address
1505 Soquel Dr Ste a
Santa Cruz, CA 95065-1716
Phone
(831) 438-5222
Fax
(831) 438-5229
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G25952 CA
Family Medicine Physician 207Q00000X G25952 CA Primary

Addresses

Primary practice location

1505 Soquel Dr Ste a
Santa Cruz, CA 95065-1716

Mailing address

216 Suburbia Ave
Santa Cruz, CA 95062-1252
Phone (831) 905-3683

Other names 1

  • Dr. David Resneck-Sannes Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110902000058 CA Practitioner - Family Practice 5799955514 Practice locations: Scotts Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5403 Scotts Valley Dr
Scotts Valley, CA 95066-3401
Phone (831) 438-5222

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Santa Cruz, CA, CCN 057007
  • Choice Home Health Care Home health agency, Monterey, CA, CCN 557461
  • Dominican Hospital Hospital, Santa Cruz, CA, CCN 050242
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

Merit-based Incentive Payment System (MIPS)

Final score
38.41 of 100Reported as individual
Quality
36.31
Improvement activities
0
Cost
79.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions11
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G25952CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern California Vasectomy Family Medicine Past Accepting new patients

Organizations & group practices 1

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 10

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742688000000",
    "number": "1114919784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SUBURBIA AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621252",
            "telephone_number": "831-905-3683",
            "fax_number": "831-438-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 SOQUEL DR STE A",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651716",
            "telephone_number": "831-438-5222",
            "fax_number": "831-438-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESNECK-SANNES",
        "first_name": "LARRY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2025-03-23",
        "certification_date": "2025-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G25952",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G25952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "RESNECK-SANNES",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.