Individual provider Active NPI

Barry Roger Zeitlin, M.D.

  • Internal Medicine Physician
  • Roseville, CA
National Provider Identifier
1750363784
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G15067 Issued in CA
Practice address
2261 Douglas Blvd
Roseville, CA 95661-3831
Phone
(916) 783-7109
Fax
(916) 774-2705
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G15067 CA Primary

Addresses

Primary practice location

2261 Douglas Blvd
Roseville, CA 95661-3831

Mailing address

2261 Douglas Blvd
Roseville, CA 95661-3831
Phone (916) 783-7109

Other identifiers 1

IdentifierTypeStateIssuer
00G150670MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G15067CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1750363784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 DOUGLAS BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613831",
            "telephone_number": "916-783-7109",
            "fax_number": "916-774-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 DOUGLAS BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613831",
            "telephone_number": "916-783-7109",
            "fax_number": "916-774-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEITLIN",
        "first_name": "BARRY",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G15067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G150670",
            "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 Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.