Individual provider Active NPI

John Robert Rostkowski, M.D.

  • Psychiatry Physician
  • Concord, CA
National Provider Identifier
1861424665
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G24111 Issued in CA
Practice address
1420 Willow Pass Rd # 200
Concord, CA 94520-5823
Phone
(925) 899-3883
Fax
(925) 229-9037
NPI assigned
Jul 6, 2006
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G24111 CA Primary

Addresses

Primary practice location

1420 Willow Pass Rd # 200
Concord, CA 94520-5823

Mailing address

1150 Arlington Way
Martinez, CA 94553-2322
Phone (925) 899-3883

Other identifiers 1

IdentifierTypeStateIssuer
00G241110MedicaidCA

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
I20111213000647 CA Practitioner - Psychiatry 1557536919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York University School of Medicine, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Contra Costa CountyGroup PAC ID 8628052974, 74 clinicians

Practice addresses (Care Compare)

1420 Willow Pass Rd
Suite 110
Concord, CA 94520-5823
Phone (925) 646-5480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G24111CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County CurrentSince Feb 22, 2017 Accepting new patients
Contra Costa County Current Accepting new patients
Contra Costa County CurrentSince Feb 22, 2017 Accepting new patients
John R. Rostkowski, M.D. P.C. PastSince Oct 10, 2011 Accepting new patients

Locations

1420 Willow Pass Rd
Ste 110
Concord, CA 94520
Phone (925) 646-5480

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1861424665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 ARLINGTON WAY",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945532322",
            "telephone_number": "925-899-3883",
            "fax_number": "925-229-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WILLOW PASS RD # 200",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205823",
            "telephone_number": "925-899-3883",
            "fax_number": "925-229-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTKOWSKI",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-03-01",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G24111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G241110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.