Penny Robillard Vandestreek, D.O.

Primary specialty

Nuclear Medicine PhysicianTaxonomy code 207U00000X

License

20A6232 Issued in CA

Practice address

1 Medical Plaza Dr
Att: Nuclear Medicine
Roseville, CA 95661-3037

Phone

(916) 781-1292

Fax

(916) 663-9912

NPI assigned

Jun 9, 2006

Last updated

Nov 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

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

Specialty

Nuclear Medicine

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
• Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
• Sutter Davis Hospital Hospital, Davis, CA, CCN 050537
• Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pvandestreekdo58591@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sutter Valley Medical Foundation

  dba Sutter Gould Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986

  Nuclear Medicine

  Medicare reassignment Care Compare group NPD
• Penny R. Vandestreek DO, Inc.

  • Nuclear Imaging & Therapy Physician
  • Roseville, CA
  • NPI 1558540526
  Authorized official Same address or phone
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1952327256
  NPD
• Sutter Regional Medical Foundation

  • Family Medicine Physician
  • Fairfield, CA
  • NPI 1558388504
  NPD (past)
• Sutter Valley Hospitals

  dba Sutter Davis Hospital

  • General Acute Care Hospital
  • Davis, CA
  • NPI 1770532608
  NPD (past)
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Valley Hospitals

  dba Sutter Auburn Faith Hospital

  • General Acute Care Hospital
  • Auburn, CA
  • NPI 1194774299
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Roseville Medical Center

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation
• Sutter Valley Hospitals

  • Home Health Agency
  • Auburn, CA
  • NPI 1417987751

  Hospital

  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Amador Hospital

  • General Acute Care Hospital
  • Jackson, CA
  • NPI 1447494323
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Davis Hospital

  • General Acute Care Hospital
  • Davis, CA
  • NPI 1770532608
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1164463402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "#100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PLAZA DR",
            "address_2": "ATT: NUCLEAR MEDICINE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613037",
            "telephone_number": "916-781-1292",
            "fax_number": "916-663-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDESTREEK",
        "first_name": "PENNY",
        "middle_name": "ROBILLARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "CA",
            "license": "20A6232",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CA",
            "license": "20A6232",
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "CA",
            "license": "20A6232",
            "primary": false
        },
        {
            "code": "207UN0903X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine",
            "state": "CA",
            "license": "20A6232",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00017739",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX62320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Vandenborn, PMHNP
• Monique A Vandenbos, M.A., LMFT
• Vanderbilt Physical Therapy
• John J. Vanderbilt Jr., MPT
• McKenna Vanderhaegen
• Frankie Vang
• Iaoo Vang, LCSW
• Sheng Linda Vang
• Brent Edward Vanhoozen, M.D.
• Nicole Vanneman, LMFT

• Nuclear Medicine Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Nuclear Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.