Active NPI
Robert D Wirtz, M.D.
- Diagnostic Radiology Physician
- Monterey, CA
National Provider Identifier
1912014796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- C32562
- Practice address
- 23625 Holman Hwy
Monterey, CA 93940-5902 - Phone
- (831) 624-5311
- Fax
- (831) 625-4948
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | C32562 | CA | |
| Neuroradiology Physician | 2085N0700X | C32562 | CA | |
| Nuclear Radiology Physician | 2085N0904X | C32562 | CA | |
| Pediatric Radiology Physician | 2085P0229X | C32562 | CA | |
| Diagnostic Radiology Physician | 2085R0202X | C32562 | CA | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | C32562 | CA | |
| Diagnostic Ultrasound Physician | 2085U0001X | C32562 | CA |
Addresses
Primary practice location
23625 Holman Hwy
Monterey, CA 93940-5902
Mailing address
P O Box HH
Business Development & Contracting
Monterey, CA 93942
Phone (831) 622-2716
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300049539 | Other | CA | RAILROAD |
| 00C325620 | Other | CA | BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| C32562 | CA | MD | Body Imaging Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456099200000",
"number": "1912014796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX HH",
"address_2": "BUSINESS DEVELOPMENT & CONTRACTING",
"city": "MONTEREY",
"state": "CA",
"postal_code": "93942",
"telephone_number": "831-622-2716",
"fax_number": "831-625-4764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23625 HOLMAN HWY",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939405902",
"telephone_number": "831-624-5311",
"fax_number": "831-625-4948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIRTZ",
"first_name": "ROBERT",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2016-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "CA",
"license": "C32562",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "CA",
"license": "C32562",
"primary": false
},
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "CA",
"license": "C32562",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "CA",
"license": "C32562",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "C32562",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "CA",
"license": "C32562",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "CA",
"license": "C32562",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "300049539",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00C325620",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monterey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.