John Carl Summer Breitner, M.D., M.P.H.

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

C134038 Issued in CA

Practice address

454 Villaggio S
Palm Springs, CA 92262-6397

Phone

(514) 441-1776

Fax

(514) 221-4700

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1598875452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 VILLAGGIO S",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626397",
            "telephone_number": "514-441-1776",
            "fax_number": "514-221-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 VILLAGGIO S",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626397",
            "telephone_number": "514-441-1776",
            "fax_number": "514-221-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITNER",
        "first_name": "JOHN",
        "middle_name": "CARL SUMMER",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "WA",
            "license": "44404",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "WA",
            "license": "44404",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CA",
            "license": "C134038",
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "C134038",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MT",
            "license": "33388",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MT",
            "license": "33388",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawnee Bradley, FNP-BC
• Chad Braun, M.D.
• Thomas Brazeal
• Breathe Thermae, Inc.
• Alec Pierce Breazeale, MD
• Mary Susan Brennan, DC
• Daniel J. Brenner, LCSW
• Eden Anne Brewster
• Brian Dunphey
• Elena Saray Bribiesca

• Geriatric Psychiatry Physician in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Geriatric Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.