Individual provider Active NPI

Rita Ann Biesen-Bradley, M.D.

  • Obstetrics & Gynecology Physician
  • Roseville, CA
National Provider Identifier
1235327388
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
C42203 Issued in CA
Practice address
8207 Sierra College Blvd
Suite 500
Roseville, CA 95661-9407
Phone
(916) 784-8660
Fax
(916) 784-7218
NPI assigned
Oct 12, 2007
Last updated
Oct 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X C42203 CA Primary

Addresses

Primary practice location

8207 Sierra College Blvd
Suite 500
Roseville, CA 95661-9407

Mailing address

8207 Sierra College Blvd
Suite 500
Roseville, CA 95661-9407
Phone (916) 784-8660

Other identifiers 1

IdentifierTypeStateIssuer
00C422030MedicaidCA

Other names 1

  • Miss Rita Ann Biesen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42203CAMDDentist
C42203CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dana R Jacques MD Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1235327388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8207 SIERRA COLLEGE BLVD",
            "address_2": "SUITE 500",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956619407",
            "telephone_number": "916-784-8660",
            "fax_number": "916-784-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8207 SIERRA COLLEGE BLVD",
            "address_2": "SUITE 500",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956619407",
            "telephone_number": "916-784-8660",
            "fax_number": "916-784-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIESEN-BRADLEY",
        "first_name": "RITA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C42203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C422030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RITA",
            "last_name": "BIESEN",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.