Individual provider Active NPI

James Horodyski, M.D.

  • Internal Medicine Physician
  • Fairfield, CA
National Provider Identifier
1184710063
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A68731 Issued in CA
Practice address
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone
(707) 429-3600
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

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
Internal Medicine Physician 207R00000X A68731 CA Primary

Addresses

Primary practice location

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552

Mailing address

1709 Dock St
Tacoma, WA 98402-3204
Phone (253) 680-1710

Other identifiers 1

IdentifierTypeStateIssuer
A68731OtherCAMEDICAL LICENSE

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
I20070427000170 CA Practitioner - Internal Medicine 3870699465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Healthcare Medical Associates IncGroup PAC ID 5294647574, 109 clinicians

Practice addresses (Care Compare)

300 Hospital Dr
Vallejo, CA 94589-2574
Phone (707) 554-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A68731CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Jan 1, 2008 Accepting new patients
Hospitalist Medicine Physicians of California, Inc Internal Medicine CurrentSince Feb 1, 2016 Accepting new patients
Sound Inpatient Physicians Medical Group Past Accepting new patients
Sound Inpatient Physicians Medical Group Inc Past Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

950 S Fairmont Ave
Lodi, CA 95240
Phone (209) 368-0693

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

347 Andrieux St
Sonoma, CA 95476
Phone (707) 935-5000

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

300 Hospital Dr
Vallejo, CA 94589
Phone (707) 554-4107

Interoperability endpoints

  • Direct secure messaging: jhorodyski50908@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184710063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 DOCK ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023204",
            "telephone_number": "253-680-1710",
            "fax_number": "253-682-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 B GALE WILSON BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333552",
            "telephone_number": "707-429-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORODYSKI",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A68731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A68731",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.