Individual provider Active NPI

Bryan Slootsky, DO

  • Physical Medicine & Rehabilitation Physician
  • Modesto, CA
National Provider Identifier
1861067985
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
20A23790 Issued in CA
Practice address
1303 Mable Ave
Modesto, CA 95355-1119
Phone
(209) 857-3400
NPI assigned
May 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 20A23790 CA Primary

Addresses

Primary practice location

1303 Mable Ave
Modesto, CA 95355-1119

Mailing address

2363 Le Conte Ave Unit B
Berkeley, CA 94709-1361
Phone (561) 702-4012

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
I20250904004503 CA Practitioner - Physical Medicine and Rehabilitation 9931500949 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael Decker DO, Inc.Group PAC ID 9830481746, 23 clinicians

Practice addresses (Care Compare)

1250 Broadway
Sonoma, CA 95476-7500
Phone (949) 371-9773

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23790CAMDChiropractor
20A23790CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Health and Rehab PC Physical Medicine & Rehabilitation CurrentSince Aug 1, 2025 Accepting new patients
Slootsky Physical Medicine & Rehabilitation, PC Physical Medicine & Rehabilitation CurrentSince Sep 22, 2025 Accepting new patients
Michael Decker, DO, Inc CurrentSince Sep 25, 2025 Accepting new patients
Integrated Rehab Consultants California Inc Physical Medicine & Rehabilitation CurrentSince Aug 10, 2025 Accepting new patients

Locations

565 Pier Ave
Unit 1352
Hermosa Beach, CA 90254
Phone (816) 896-1355

16412 Los Gatos Blvd
Los Gatos, CA 95032
Phone (408) 356-2191

1303 Mable Ave
Modesto, CA 95355
Phone (209) 232-4350

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

7716 W Manchester Ave
Playa del Rey, CA 90293
Phone (310) 823-4694

3688 Nye Ave
Riverside, CA 92505
Phone (951) 351-2800

340 Northlake Dr
San Jose, CA 95117
Phone (408) 249-0344

1250 Broadway
Sonoma, CA 95476
Phone (707) 938-8406

8647 Fenwick St
Sunland, CA 91040
Phone (818) 352-1421

Interoperability endpoints

  • Direct secure messaging: bryan.slootsky@104097756413956.direct.elationemr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1861067985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2363 LE CONTE AVE UNIT B",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091361",
            "telephone_number": "561-702-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MABLE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551119",
            "telephone_number": "209-857-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOOTSKY",
        "first_name": "BRYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A23790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.