Active NPI
Ivan Rodrigo Kiryluk Putziger, M.D.
- Psychiatry Physician
- Vacaville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A125612
- Practice address
- 1600 California Dr.
Vacaville, CA 95687 - Phone
- (707) 448-6841
- NPI assigned
- May 11, 2009
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | A125612 | CA | Primary |
Addresses
Primary practice location
1600 California Dr.
Vacaville, CA 95687
Mailing address
1600 California Dr.
Vacaville, CA 95687
Phone (707) 448-6841
Other names 1
- Dr. Ivan Kiryluk Putziger
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
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Emory University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3100 Oak Rd
Suite 270
Walnut Creek, CA 94597-2078
Phone (925) 944-9711
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A125612 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yolo County Health and Human Services Agency | Current | Accepting new patients | |
| Yolo County Health and Human Services Agency | Current | Accepting new patients | |
| Comprehensive Psychiatric Services, a Medical Group | Psychiatry | Current | Accepting new patients |
| Yolo County Health and Human Services Agency | Current | Accepting new patients |
Locations
600 A St
Davis, CA 95616
Phone (530) 204-9467
611 Gateway Blvd
Ste 120
South San Francisco, CA 94080
Phone (650) 480-6023
611 Gateway Blvd
Ste 210
South San Francisco, CA 94080
3100 Oak Rd
Ste 270
Walnut Creek, CA 94597
Phone (925) 944-9711
500 Jefferson Blvd
Ste B150
West Sacramento, CA 95605
Phone (916) 375-6350
137 N Cottonwood St
Woodland, CA 95695
Phone (530) 666-8645
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Walnut Creek, CA
- NPI 1184785834
-
- Community/Behavioral Health Agency
- Davis, CA
- NPI 1053443135
-
- Community/Behavioral Health Agency
- Woodland, CA
- NPI 1144352220
-
- Community/Behavioral Health Agency
- Woodland, CA
- NPI 1346446432
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1346474921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 CALIFORNIA DR.",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "95687",
"telephone_number": "707-448-6841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 CALIFORNIA DR.",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "95687",
"telephone_number": "707-448-6841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTZIGER",
"first_name": "IVAN",
"middle_name": "RODRIGO KIRYLUK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-11",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"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": "A125612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "IVAN",
"last_name": "PUTZIGER",
"middle_name": "KIRYLUK",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.