Individual provider Active NPI

Peter John Holewinski

  • Specialist
  • Santa Rosa, CA
National Provider Identifier
1972053114
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
HCO494700016 Issued in CA
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

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
HCO494700016CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.