Active NPI
Brian Prystowsky, M.D.
- Pediatrics Physician
- Santa Rosa, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A108906
- Practice address
- 3569 Round Barn Cir
Santa Rosa, CA 95403-5781 - Phone
- (707) 303-3600
- Fax
- (707) 303-3611
- NPI assigned
- Apr 26, 2007
- Last updated
- Oct 28, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A108906 | CA | Primary |
Addresses
Primary practice location
3569 Round Barn Cir
Santa Rosa, CA 95403-5781
Mailing address
3569 Round Barn Cir
Santa Rosa, CA 95403-5781
Phone (707) 303-3600
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A108906 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Bay Medical Foundation | Pediatrics | Current | Accepting new patients |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Sutter West Bay Medical Foundation | Pediatrics | Past | Accepting new patients |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Hma Santa Rosa Medical Center LLC | Past | Accepting new patients | |
| Sutter Bay Hospitals | Past | Accepting new patients |
Locations
131 Stony Cir
Ste 1600
Santa Rosa, CA 95401
Phone (707) 541-7700
3569 Round Barn Cir
Santa Rosa, CA 95403
3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750
4702 Hoen Ave
Santa Rosa, CA 95405
Phone (707) 545-2255
500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842
Interoperability endpoints
- bprystowsky233895@hisp.ehr.sutterhealth.org
Organizations & group practices 7
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 Palo Alto Medial Foundation
- Multi-Specialty Clinic/Center
- Palo Alto, CA
- NPI 1013950807
-
dba Sutter Pacific Medical Foundation
- Multi-Specialty Clinic/Center
- Sacramento, CA
- NPI 1003267196
Pediatrics
-
dba Palo Alto Medical Foundation
- Clinical Medical Laboratory
- Santa Clara, CA
- NPI 1669287033
-
dba Providence Santa Rosa Memorial Hospital
- General Acute Care Hospital
- Santa Rosa, CA
- NPI 1134152549
-
- General Acute Care Hospital
- Santa Rosa, CA
- NPI 1740413798
-
dba Sutter Pacific Medical Foundation
- Family Medicine Physician
- San Francisco, CA
- NPI 1104852789
Pediatrics
-
dba Santa Rosa Medical Center
- General Acute Care Hospital
- Milton, FL
- NPI 1528015302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319760000000",
"number": "1629298112",
"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": "954035781",
"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": "954035781",
"telephone_number": "707-303-3600",
"fax_number": "707-303-3611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRYSTOWSKY",
"first_name": "BRIAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2011-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A108906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.