Active NPI
Peter John Holewinski
- Specialist
- Santa Rosa, CA
National Provider Identifier
1972053114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- HCO494700016
- Practice address
- 170 Farmers LN Ste 11
Santa Rosa, CA 95405-4750 - Phone
- (707) 843-3851
- Fax
- (707) 595-3227
- NPI assigned
- Oct 12, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | HCO494700016 | CA | Primary |
Addresses
Primary practice location
170 Farmers LN Ste 11
Santa Rosa, CA 95405-4750
Mailing address
170 Farmers LN Ste 11
Santa Rosa, CA 95405-4750
Phone (707) 843-3851
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HCO494700016 | CA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Flat Ranch, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- In Home Supportive Care Agency
- Santa Rosa, CA
- NPI 1396295531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476230400000",
"number": "1972053114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 FARMERS LN STE 11",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954054750",
"telephone_number": "707-843-3851",
"fax_number": "707-595-3227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 FARMERS LN STE 11",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954054750",
"telephone_number": "707-843-3851",
"fax_number": "707-595-3227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLEWINSKI",
"first_name": "PETER",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-12",
"last_updated": "2016-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "HCO494700016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.