Individual provider Active NPI

Thomas Bottyan

  • Psychiatry Physician
  • Palo Alto, CA
National Provider Identifier
1326579475
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A160069 Issued in CA
Practice address
401 Quarry Rd Uppr Ca94304
Palo Alto, CA 94304-1419
Phone
(650) 723-8335
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X A160069 CA
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X A160069 CA Primary

Addresses

Primary practice location

401 Quarry Rd Uppr Ca94304
Palo Alto, CA 94304-1419

Mailing address

401 Quarry Rd Uppr Ca94304
Palo Alto, CA 94304-1419
Phone (650) 723-8335

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A160069CAMDAddiction Medicine (Psychiatry & Neurology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1326579475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 QUARRY RD UPPR CA94304",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041419",
            "telephone_number": "650-723-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 QUARRY RD UPPR CA94304",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041419",
            "telephone_number": "650-723-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTYAN",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "A160069",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A160069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.