Active NPI
Bonnie M Rathjen, M.D.
- Internal Medicine Physician
- Pleasanton, CA
National Provider Identifier
1952331852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G43694
- Practice address
- 4125 Mohr Ave
Suite E-2
Pleasanton, CA 94566-4749 - Phone
- (925) 462-3664
- Fax
- (925) 462-3666
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G43694 | CA | Primary |
Addresses
Primary practice location
4125 Mohr Ave
Suite E-2
Pleasanton, CA 94566-4749
Mailing address
4125 Mohr Ave
Suite E-2
Pleasanton, CA 94566-4749
Phone (925) 462-3664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 30, 2017 through Jun 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43694 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1952331852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4125 MOHR AVE",
"address_2": "SUITE E-2",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945664749",
"telephone_number": "925-462-3664",
"fax_number": "925-462-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4125 MOHR AVE",
"address_2": "SUITE E-2",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945664749",
"telephone_number": "925-462-3664",
"fax_number": "925-462-3666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RATHJEN",
"first_name": "BONNIE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G43694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.