Active NPI
Peter Daniel Jurisich, D.O.
- Cardiovascular Disease Physician
- Roseville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 20A8542
- Practice address
- 2 Medical Plaza Dr Ste 175
Roseville, CA 95661-3049 - Phone
- (916) 782-2146
- NPI assigned
- Jul 30, 2006
- Last updated
- Feb 28, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 20A8542 | CA | |
| Cardiovascular Disease Physician | 207RC0000X | 20A8542 | CA | Primary |
Addresses
Primary practice location
2 Medical Plaza Dr Ste 175
Roseville, CA 95661-3049
Mailing address
2 Medical Plaza Dr Ste 175
Roseville, CA 95661-3049
Phone (916) 782-2146
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX85420 | Medicaid | CA | |
| 1671625 | Other | CA | GREAT WEST |
| 7450546 | Other | CA | AETNA |
| 020A85420 | Other | CA | BLUE SHIELD |
| 2361104 | Other | CA | UNITED HEALTHCARE |
| 4911481 | Other | CA | CIGNA |
| 95883 | Other | CA | INTERPLAN |
| 2121684 | Other | CA | FIRST HEALTH |
| 90136861 | Other | CA | PACIFICARE |
| 000810778930 | Other | CA | PHCS |
| 102287 | Other | CA | HEALTH NET |
| 20A542 | Other | CA | BLUE CROSS |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868
100 Mission Blvd
Jackson, CA 95642-2536
2 Medical Plaza Dr
Roseville, CA 95661-3042
2 Medical Plaza Dr
Suite 205
Roseville, CA 95661-3044
Phone (916) 773-8711
2575 E Bidwell St
Suite 100
Folsom, CA 95630-6445
Phone (916) 817-3710
2800 L St
Sacramento, CA 95816-5616
2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600
3288 Bell Rd
Auburn, CA 95603-9243
Phone (530) 886-2300
3320 Bell Rd
Auburn, CA 95603-9243
Phone (530) 888-1266
5765 Greenback LN
Sacramento, CA 95841-2013
Phone (916) 865-1040
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 40 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8542 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Medical Foundation | Family Medicine | Current | Accepting new patients |
| Roseville Cardiology Medical Associates, Inc. | Cardiovascular Disease | Current | Accepting new patients |
| Sutter Valley Medical Foundation | Current | Accepting new patients | |
| Sutter Tracy Community Hospital | Past | Accepting new patients | |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Ukiah Adventist Hospital | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Port City Operating Company, LLC | Past | Accepting new patients | |
| Dameron Hospital Association | Cardiovascular Disease | Past | Accepting new patients |
| Sutter Regional Medical Foundation | Family Medicine | Past | Accepting new patients |
| Oroville Hospital | Past | Accepting new patients | |
| Sutter Valley Hospitals | Past | Accepting new patients | |
| Lodi Memorial Hospital Association Inc | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients |
Locations
3288 Bell Rd
Auburn, CA 95603
Phone (530) 886-2300
685 Twelve Bridges Dr
Ste G
Lincoln, CA 95648
Phone (916) 408-5478
2 Medical Plaza Dr
Ste 175
Roseville, CA 95661
Phone (916) 782-2146
2 Medical Plaza Dr
Ste 250
Roseville, CA 95661
Phone (916) 786-3824
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
Interoperability endpoints
- pjurisich192626@hisp.ehr.sutterhealth.org
Organizations & group practices 14
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.
-
dba Sutter Gould Medical Foundation
- Multi-Specialty Clinic/Center
- Modesto, CA
- NPI 1669846986
Family Medicine
-
- Cardiovascular Disease Physician
- Roseville, CA
- NPI 1699718312
-
- Durable Medical Equipment & Medical Supplies
- Tracy, CA
- NPI 1720930712
-
- General Acute Care Hospital
- Stockton, CA
- NPI 1538163886
Cardiovascular Disease
-
dba Mercy San Juan Medical Center
- General Acute Care Hospital
- Carmichael, CA
- NPI 1972541498
-
dba Lodi Memorial Hospital Acute Physical Rehabilitation Unit
- Rehabilitation Hospital Unit
- Lodi, CA
- NPI 1821028671
-
- Clinic/Center
- Oroville, CA
- NPI 1780788018
-
dba St. Joseph's Medical Center of Stockton
- General Acute Care Hospital
- Stockton, CA
- NPI 1528190931
-
dba Providence Santa Rosa Memorial Hospital
- General Acute Care Hospital
- Santa Rosa, CA
- NPI 1134152549
-
- Family Medicine Physician
- Fairfield, CA
- NPI 1558388504
-
- General Acute Care Hospital
- Tracy, CA
- NPI 1043291164
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sutter Auburn Faith Hospital
- General Acute Care Hospital
- Auburn, CA
- NPI 1194774299
-
dba Sutter Roseville Medical Center
- General Acute Care Hospital
- Roseville, CA
- NPI 1356390264
-
- General Acute Care Hospital
- Sacramento, CA
- NPI 1811946734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393545600000",
"number": "1629083407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MEDICAL PLAZA DR STE 175",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956613049",
"telephone_number": "916-782-2146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 MEDICAL PLAZA DR STE 175",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956613049",
"telephone_number": "916-782-2146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURISICH",
"first_name": "PETER",
"middle_name": "DANIEL",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-30",
"last_updated": "2014-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "CA",
"license": "20A8542",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "20A8542",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX85420",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "1671625",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7450546",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "020A85420",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2361104",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4911481",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERPLAN",
"identifier": "95883",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2121684",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE",
"identifier": "90136861",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "000810778930",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "102287",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "20A542",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.