Individual provider Active NPI

Robert Brian Connor, MD

  • Psychiatry Physician
  • Santa Rosa, CA
National Provider Identifier
1649260506
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C53411 Issued in CA
Practice address
1287 Fulton Rd
Santa Rosa, CA 95401-4923
Phone
(707) 800-7700
NPI assigned
Oct 24, 2005
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X C53411 CA
Psychiatry Physician 2084P0800X C53411 CA Primary

Addresses

Primary practice location

1287 Fulton Rd
Santa Rosa, CA 95401-4923

Mailing address

1450 W Long Lake Rd Ste 340
Troy, MI 48098-6330
Phone (248) 905-5091

Other identifiers 1

IdentifierTypeStateIssuer
600946111OtherCAMAGELLAN HEALTH

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210914001890 CA Practitioner - Psychiatry 7517281561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Psychiatric Solutions, PCGroup PAC ID 0042629701, 6 clinicians

Practice addresses (Care Compare)

1287 Fulton Rd
Santa Rosa, CA 95401-4923
Phone (707) 800-7700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C53411CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Torrico Medical Group Inc Psychiatry CurrentSince Sep 1, 2025 Accepting new patients
Comprehensive Psychiatric Solutions, P.C. Psychiatry CurrentSince Jul 1, 2021 Accepting new patients

Locations

1287 Fulton Rd
Santa Rosa, CA 95401
Phone (707) 543-2031

1450 W Long Lake Rd
Ste 340
Troy, MI 48098
Phone (248) 839-5381

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1649260506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 W LONG LAKE RD STE 340",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986330",
            "telephone_number": "248-905-5091",
            "fax_number": "248-905-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 FULTON RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014923",
            "telephone_number": "707-800-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "ROBERT",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "C53411",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C53411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH",
            "identifier": "600946111",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.