NPIMap

Individual provider Active NPI

Andrew James Desruisseau, M.D.

  • Infectious Disease Physician
  • Santa Rosa, CA
National Provider Identifier
1518945658
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
C54607 Issued in CA
Practice address
3569 Round Barn Cir
Santa Rosa, CA 95403-1757
Phone
(707) 303-3600
Fax
(707) 303-3611
NPI assigned
Jan 9, 2006
Last updated
Apr 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 38871 TN
Infectious Disease Physician 207RI0200X C54607 CA Primary

Addresses

Primary practice location

3569 Round Barn Cir
Santa Rosa, CA 95403-1757

Mailing address

3569 Round Barn Cir
Santa Rosa, CA 95403-1757
Phone (707) 303-3600

Other identifiers 1

IdentifierTypeStateIssuer
3897593MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018002274 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 3577522614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.1 of 100Reported as individual
Quality
96.63
Improvement activities
0
Cost
81.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38871TNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of California UCSF Infectious Disease CurrentSince Dec 21, 2019 Accepting new patients
Healthright 360 CurrentSince Sep 21, 2018 Accepting new patients
Healthright 360 CurrentSince Sep 21, 2018 Accepting new patients
Healthright 360 Current Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
Metropolitan Interdenominational Church Infectious Disease Past Accepting new patients
Marin General Hospital Past Accepting new patients
Nashville General Hospital Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

330 Ellis St
San Francisco, CA 94102
Phone (415) 674-6085

330 Ellis St
Ste 600
San Francisco, CA 94102

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

558 Clayton St
San Francisco, CA 94117
Phone (415) 746-1950

Interoperability endpoints

  • Direct secure messaging: adesruisseau121297@direct-ucsfmedicalcenter.org

Organizations & group practices 9

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1518945658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031757",
            "telephone_number": "707-303-3600",
            "fax_number": "707-303-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031757",
            "telephone_number": "707-303-3600",
            "fax_number": "707-303-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESRUISSEAU",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TN",
            "license": "38871",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "C54607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3897593",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.