Individual provider Active NPI

Peter D Bravos, M.D.

  • Anesthesiology Physician
  • Yuba City, CA
National Provider Identifier
1346292091
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A72361 Issued in CA
Practice address
460 Plumas Blvd
Suite 202
Yuba City, CA 95991
Phone
(530) 749-5500
Fax
(530) 749-5520
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A72361 CA Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X A72361 CA

Addresses

Primary practice location

460 Plumas Blvd
Suite 202
Yuba City, CA 95991

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other identifiers 2

IdentifierTypeStateIssuer
00A723610OtherCABS OF CA
00A723610MedicaidCA

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
I20050408000404 CA Practitioner - AnesthesiologyPractitioner - Pain Management 7113964446 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72361CAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Anesthesiology Current Accepting new patients
Rideout Memorial Hospital Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Twin Cities Surgical Hospital LLC Past Accepting new patients

Locations

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: pbravosmd20644@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1346292091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 PLUMAS BLVD",
            "address_2": "SUITE 202",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "95991",
            "telephone_number": "530-749-5500",
            "fax_number": "530-749-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVOS",
        "first_name": "PETER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A72361",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A72361",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF CA",
            "identifier": "00A723610",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A723610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.