Individual provider Active NPI

John Phillip Hurwitz, DO

  • Internal Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1124018262
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2OA6856 Issued in CA
Practice address
3751 Montgomery Dr
Santa Rosa, CA 95405-5214
Phone
(707) 583-1805
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2OA6856 CA Primary
Hospitalist Physician 208M00000X 2OA6856 CA

Addresses

Primary practice location

3751 Montgomery Dr
Santa Rosa, CA 95405-5214

Mailing address

122 Calistoga Rd
Suite 197
Santa Rosa, CA 95409-3702

Other identifiers 1

IdentifierTypeStateIssuer
9645038MedicaidCA

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
I20080306000680 CA Practitioner - Internal Medicine 4183709710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
17.08 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
56.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2OA6856CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Phillip Hurwitz MD a Professional Corporation Internal Medicine CurrentSince Sep 1, 1998 Accepting new patients

Locations

2100 Forest Ave
Ste 108
San Jose, CA 95128
Phone (408) 240-2614

3751 Montgomery Dr
Santa Rosa, CA 95405
Phone (253) 212-7129

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

122 Calistoga Rd
Santa Rosa, CA 95409
Phone (707) 341-6829

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.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1124018262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 CALISTOGA RD",
            "address_2": "SUITE 197",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954055214",
            "telephone_number": "707-583-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURWITZ",
        "first_name": "JOHN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "2OA6856",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "2OA6856",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9645038",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.