Jeffrey R Breneisen, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G86677 Issued in CA

Practice address

1860 Pennsylvania Ave
Suite 120
Fairfield, CA 94533-3590

Phone

(707) 646-4400

Fax

(707) 646-4401

NPI assigned

Jan 18, 2006

Last updated

Jul 31, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northbay Medical Center Hospital, Fairfield, CA, CCN 050367
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/UMZ-Uxn6V9x08sH5gCnG-5yPg9ZX7et6/

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.

• Northbay Health Medical Foundation

  dba NorthBay Health Medical Network

  • Internal Medicine Physician
  • Fairfield, CA
  • NPI 1760283527

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Northbay Healthcare Group

  dba dba NorthBay Medical Center

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Medicare reassignment Care Compare group NPD
• Northbay Healthcare Group

  dba NorthBay VacaValley Hospital

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD
• Northbay Physicians Surgery Center LLC

  dba The Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Vacaville, CA
  • NPI 1003015843
  NPD (past)

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

• Northbay Healthcare Group

  dba dba NorthBay Medical Center

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1629058615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE",
            "address_2": "SUITE 120",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333590",
            "telephone_number": "707-646-4400",
            "fax_number": "707-646-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE",
            "address_2": "SUITE 120",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333590",
            "telephone_number": "707-646-4400",
            "fax_number": "707-646-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENEISEN",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G86677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G866770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caryssa Cheyenne Brandt
• Anna Branscum
• Emmeri L Branson
• Katrina Brass
• Yvette Bravo
• Laurie Bresee
• Bridge Hospice Solano LLC (Bridge Hospice)
• Chelsea Keshawn Bridges
• Bridgewell Care LLC
• Sarah Kim Briggs

• Cardiovascular Disease Physician in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.

Verify at the official NPI Registry.