Neil J Nathan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R5C40 Issued in MO

Practice address

3471 Regional Pkwy
Santa Rosa, CA 95403-8209

Phone

(707) 575-5180

NPI assigned

Sep 29, 2005

Last updated

Apr 1, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2015 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Neil Nathan MD PC

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1750414868
  NPD (past) Authorized official
• Redwood Valley Health Clinic, Inc.

  • Family Medicine Physician
  • Redwood Valley, CA
  • NPI 1477853877
  NPD (past)
• Willits Hospital Inc.

  dba Adventist Health Howard Memorial

  • Critical Access Hospital
  • Willits, CA
  • NPI 1356339543
  NPD (past)

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1174510788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3471 REGIONAL PKWY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038209",
            "telephone_number": "707-575-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3471 REGIONAL PKWY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038209",
            "telephone_number": "707-575-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "NEIL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R5C40",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00140692",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yizza Narvaez, M.D.
• Jalicia Lynea Nasibebo
• Hachem Nasri, M.D.
• Judy Nassimbene
• Natalie Goldstone DDS Dental Corporation
• National Seating & Mobility, Inc
• National Seating & Mobility, Inc.
• National Vision, Inc. (America's Best Contacts & Eyeglasses)
• Nicole Natividad
• Trea Nattkemper, SUDRC I

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.