NPIMap

Individual provider Active NPI

Sean Edward Purtell, MD

  • Hospitalist Physician
  • Eureka, CA
National Provider Identifier
1609432434
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A177295 Issued in CA
Practice address
2700 Dolbeer St
Eureka, CA 95501-4736
Phone
(707) 445-8121
NPI assigned
May 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A177295 CA
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X A177295 CA Primary

Addresses

Primary practice location

2700 Dolbeer St
Eureka, CA 95501-4736

Mailing address

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-8121

Other practice location 1

3300 Renner Dr
Fortuna, CA 95540-3120
Phone (707) 269-4253

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
I20220726001276 CA Practitioner - HospitalistPractitioner - Family Practice 2062893852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-8121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177295CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Family Medicine CurrentSince Jul 11, 2022 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jul 11, 2022 Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229

3300 Renner Dr
Fortuna, CA 95540
Phone (707) 725-3361

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1609432434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 DOLBEER ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014736",
            "telephone_number": "707-445-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 DOLBEER ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014736",
            "telephone_number": "707-445-8121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Renner Dr",
            "address_purpose": "LOCATION",
            "city": "Fortuna",
            "state": "CA",
            "postal_code": "955403120",
            "country_code": "US",
            "telephone_number": "707-269-4253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURTELL",
        "first_name": "SEAN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-16",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A177295",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A177295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.