PNC MSK, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PNC MSK, PC

Practice address

172 Washington Ave Ste a
Ukiah, CA 95482-6319

Phone

(707) 462-4136

Fax

(310) 791-1087

NPI assigned

Sep 11, 2024

Organization subpart

Yes

Parent organization

PNC MSK, PCAs reported in NPPES

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

Authorized official

Name

Alexander Reyzelman, DPM

Title

Rcmo

Phone

(415) 292-0638

Specialties & licenses 2

Addresses

Part of

PNC MSK PC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• PNC MSK, PC

  • Orthopaedic Surgery Physician
  • Santa Rosa, CA
  • NPI 1770216855
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Koji Fujii, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Carmichael, CA
  • NPI 1235391798
  NPD (past)
• Jonathan Ben Kreger, DPM

  • Podiatrist
  • Ukiah, CA
  • NPI 1538232731
  NPD (past)

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1871329375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33445",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049150612",
            "telephone_number": "415-645-4525",
            "fax_number": "510-399-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 WASHINGTON AVE STE A",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954826319",
            "telephone_number": "707-462-4136",
            "fax_number": "310-791-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNC MSK, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PNC MSK, PC",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "REYZELMAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "RCMO",
        "authorized_official_telephone_number": "415-292-0638",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben Pinol, B.S. HEALTH SCIENCE
• Gabriella Pinola
• Reuben Jose Pinola Sr.
• Jamie Pitman
• Planned Parenthood Shasta Diablo, Inc
• Gonzalo L Poe
• Susan Ruth Pollesel, MA CCC SP.
• Kimberly Poor
• Gregory G Porter, MD
• Jon Stephen Portnoff, M.D.

• Foot & Ankle Surgery Podiatrist in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.