Individual provider Active NPI

Bryan Tsujimoto

  • Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1124661186
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
108 La Casa Via Ste 100
Walnut Creek, CA 94598-3013
Phone
(925) 930-9120
NPI assigned
Oct 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

108 La Casa Via Ste 100
Walnut Creek, CA 94598-3013

Mailing address

108 La Casa Via Ste 100
Walnut Creek, CA 94598-3013
Phone (925) 930-9120

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191218001765 CA Practitioner - Physician Assistant 2466886817 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2671 Blanding Ave
Suite a
Alameda, CA 94501-1587
Phone (510) 694-4816

2690 5TH St
Suite B
Alameda, CA 94501-6584
Phone (510) 439-9447

2920 Telegraph Ave
Suite 100
Berkeley, CA 94705-2031
Phone (510) 686-3621

411 Grand Ave
Oakland, CA 94610-5022
Phone (510) 844-4097

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group CurrentSince Nov 11, 2019 Accepting new patients
Bass Medical Group CurrentSince Nov 11, 2019 Accepting new patients
Bass Medical Group Past Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

108 La Casa Via
Ste 100
Walnut Creek, CA 94598
Phone (925) 930-9120

Interoperability endpoints

  • Direct secure messaging: btsujimoto131404@ehr.johnmuirhealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IBDGCA

Organizations & group practices 5

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 1

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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1124661186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 LA CASA VIA STE 100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983013",
            "telephone_number": "925-930-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 LA CASA VIA STE 100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983013",
            "telephone_number": "925-930-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUJIMOTO",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-22",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.