Individual provider Active NPI

Bruce M Espenshade, MD

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1265655237
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C139297 Issued in CA
Practice address
401 Bicentennial Way
Santa Rosa, CA 95403-2149
Phone
(707) 963-6399
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 42342 KY
Family Medicine Physician 207Q00000X C139297 CA Primary
Family Medicine Physician 207Q00000X 42342 KY
Hospitalist Physician 208M00000X C139297 CA

Addresses

Primary practice location

401 Bicentennial Way
Santa Rosa, CA 95403-2149

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other identifiers 5

IdentifierTypeStateIssuer
000000601798OtherKYBCBS
K042110OtherKYMEDICARE- NORTON HEALTHCARE
201140380MedicaidIN
000000759205OtherKYANTHEM-NICC
7100068760MedicaidKY

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
I20160524000534 CA Practitioner - Family PracticePractitioner - Hospitalist 3072677095 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

401 Bicentennial Way
Santa Rosa, CA 95403-2149
Phone (707) 393-4000

7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000

Hospital & facility affiliations

  • Kaiser Foundation Hospital-Santa Rosa Hospital, Santa Rosa, CA, CCN 050690

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42342KYMDEmergency Medicine Physician
C139297CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of California, Inc Family Medicine CurrentSince Feb 1, 2022 Accepting new patients
County of Santa Clara Emergency Medicine CurrentSince Apr 8, 2017 Accepting new patients
County of Santa Clara Current Accepting new patients
Lodi Memorial Hospital Association Inc CurrentSince Jan 19, 2019 Accepting new patients
Lodi Memorial Hospital Association, Inc Current Accepting new patients
Permanente Medical Group, Inc CurrentSince May 13, 2024 Accepting new patients
County of Santa Clara CurrentSince Apr 8, 2017 Accepting new patients
Permanente Medical Group Inc Emergency Medicine CurrentSince May 13, 2024 Accepting new patients
Inpatient Specialists of California, PC Family Medicine CurrentSince Oct 15, 2022 Accepting new patients
Permanente Medical Group Inc Emergency Medicine Current Accepting new patients
Cogent Healthcare of Kentucky, PSC Family Medicine Past Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 963-2002

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

401 Bicentennial Way
Santa Rosa, CA 95403
Phone (707) 393-4000

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

1100 Las Tablas Rd
Templeton, CA 93465
Phone (805) 434-3500

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 11

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1265655237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BICENTENNIAL WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032149",
            "telephone_number": "707-963-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPENSHADE",
        "first_name": "BRUCE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "42342",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C139297",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "42342",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "C139297",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000601798",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- NORTON HEALTHCARE",
            "identifier": "K042110",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201140380",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-NICC",
            "identifier": "000000759205",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100068760",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.