Individual provider Active NPI

Brent Etiz

  • Anesthesiology Physician
  • Stanford, CA
National Provider Identifier
1447909676
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
77537 Issued in AZ
Practice address
300 Pasteur Dr
Stanford, CA 94305-5133
Phone
(650) 723-6661
Fax
(650) 498-6205
NPI assigned
Mar 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 77537 AZ Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-5133

Mailing address

16309 Payton
Irvine, CA 92620-3472
Phone (559) 213-1225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20260618003247 AZ Practitioner - Anesthesiology 9032681135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1525 NW 62ND St
Fort Lauderdale, FL 33309-1831

451 Roosevelt Ave
Redwood City, CA 94061-2244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1447909676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16309 PAYTON",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203472",
            "telephone_number": "559-213-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055133",
            "telephone_number": "650-723-6661",
            "fax_number": "650-498-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIZ",
        "first_name": "BRENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "77537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.