Individual provider Active NPI

Nicholas Prewitt, MD

  • Emergency Medicine Physician
  • Pleasanton, CA
National Provider Identifier
1992445324
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A200408 Issued in CA
Practice address
5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone
(844) 301-0805
NPI assigned
Apr 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A200408 CA Primary

Addresses

Primary practice location

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000

Mailing address

PO Box 920133
Dallas, TX 75392-0133
Phone (877) 346-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250619000994 CA Practitioner - Emergency Medicine 5698286235 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A200408CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pleasanton Emergency Medical Group Emergency Medicine CurrentSince Jun 1, 2025 Accepting new patients

Locations

4000 Dublin Blvd
Ste 150
Dublin, CA 94568
Phone (813) 732-7842

1133 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4500

1111 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4018

5555 W Las Positas Blvd
Pleasanton, CA 94588
Phone (925) 416-3418

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": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1992445324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920133",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920133",
            "telephone_number": "877-346-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W LAS POSITAS BLVD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884000",
            "telephone_number": "844-301-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREWITT",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-01",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A200408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.