Individual provider Active NPI

Brian A Bartlett, DC

  • Chiropractor
  • Santa Rosa, CA
National Provider Identifier
1154426930
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC23426 Issued in CA
Practice address
2718 Tachevah Drive
Santa Rosa, CA 95405
Phone
(707) 579-8150
Fax
(707) 579-8161
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC23426 CA Primary

Addresses

Primary practice location

2718 Tachevah Drive
Santa Rosa, CA 95405

Mailing address

2718 Tachevah Drive
Santa Rosa, CA 95405
Phone (707) 579-8150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050803001120 CA Practitioner - Chiropractic 9234167800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2718 Tachevah Dr
Santa Rosa, CA 95405-8420
Phone (707) 579-8150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23426CAMDPsychologist
DC23426CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bartlett Chiropractic, Inc CurrentSince Aug 24, 2013 Accepting new patients

Locations

2718 Tachevah Dr
Santa Rosa, CA 95405
Phone (707) 579-8150

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154426930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718 TACHEVAH DRIVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-579-8150",
            "fax_number": "707-579-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 TACHEVAH DRIVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-579-8150",
            "fax_number": "707-579-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "BRIAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.