Penscott Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G53582 Issued in CA

Legal business name

PENSCOTT MEDICAL CORPORATION

Practice address

4165 Blackhawk Plaza Cir
#250
Danville, CA 94506-4904

Phone

(925) 736-8510

Fax

(925) 736-2491

NPI assigned

Sep 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John William Roberts, MDNPI 1700856978

Title

President

Phone

(925) 736-8510

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pamela McDonald, W.H.N.P., A.N.P.

  • Women's Health Nurse Practitioner
  • Danville, CA
  • NPI 1255311809
  Medicare reassignment NPD
• John William Roberts, M.D.

  • Family Medicine Physician
  • Danville, CA
  • NPI 1700856978
  NPD (past) Authorized official
• Leslie Merken, P.T.

  • Orthopedic Physical Therapist
  • Walnut Creek, CA
  • NPI 1700985215
  NPD (past)
• Thomas G Quinn, M.D.

  • Cardiovascular Disease Physician
  • Oakland, CA
  • NPI 1851407258
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316038920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR",
            "address_2": "#250",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064904",
            "telephone_number": "925-736-8510",
            "fax_number": "925-736-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR",
            "address_2": "#250",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064904",
            "telephone_number": "925-736-8510",
            "fax_number": "925-736-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSCOTT MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-736-8510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G53582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nimish G Patel, D.O.
• Kathie Bright Paulson, RPH
• Eliza Rose Pedder, MA, AMFT, APCC
• Stephanie Peek, ACSW, PPSC
• Xochil Pelayo
• Lorraine Perez
• Tatiana K Perez
• Zachary Perez
• Christopher Pescatore, D.M.D.
• Petar Guest Homes, Inc.

• Family Medicine Physician in Danville, CA
• Providers in Danville, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.