Active NPI
Bryan O Barnett, MD
- Dermatology Physician
- Tracy, CA
National Provider Identifier
1295713295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G49728
- Practice address
- 1542A N Tracy Blvd
Tracy, CA 95376-2903 - Phone
- (209) 836-2220
- Fax
- (209) 836-0726
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G49728 | CA | Primary |
Addresses
Primary practice location
1542A N Tracy Blvd
Tracy, CA 95376-2903
Mailing address
1542A N Tracy Blvd
Tracy, CA 95376-2903
Phone (209) 836-2220
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070314000487 | CA | Practitioner - Dermatology | 8527161447 | Practice locations: Tracy, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G49728 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490572800000",
"number": "1295713295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1542A N TRACY BLVD",
"city": "TRACY",
"state": "CA",
"postal_code": "953762903",
"telephone_number": "209-836-2220",
"fax_number": "209-836-0726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1542A N TRACY BLVD",
"city": "TRACY",
"state": "CA",
"postal_code": "953762903",
"telephone_number": "209-836-2220",
"fax_number": "209-836-0726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARNETT",
"first_name": "BRYAN",
"middle_name": "O",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2017-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G49728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.