PETER DANIEL JURISICH (NPI# 1629083407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629083407 |
| Entity Type | Individual |
| Full Name | PETER DANIEL JURISICH |
| Credential | D.O. |
| Practice Address |
2 Medical Plaza Dr Ste 175 Roseville CA 95661-3049 |
| Practice Telephone | 9167822146 |
| Mailing Telephone | 9167822146 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2014-02-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
20A8542 | CA | Allopathic & Osteopathic Physicians |
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
20A8542 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | HEALTH NET | 102287 | 01 |
| CA | AETNA | 7450546 | 01 |
| CA | 00AX85420 | 05 | |
| CA | UNITED HEALTHCARE | 2361104 | 01 |
| CA | CIGNA | 4911481 | 01 |
| CA | PACIFICARE | 90136861 | 01 |
| CA | BLUE SHIELD | 020A85420 | 01 |
| CA | BLUE CROSS | 20A542 | 01 |
| CA | PHCS | 000810778930 | 01 |
| CA | FIRST HEALTH | 2121684 | 01 |
| CA | INTERPLAN | 95883 | 01 |
| CA | GREAT WEST | 1671625 | 01 |
| Street Address |
2 MEDICAL PLAZA DR STE 175 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661-3049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427608942 | Erin Elizabeth Shiue | Physician Assistant | 2 Medical Plaza Dr Ste 175, Roseville, CA 95661-3049 | 2019-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725789 | Norcal Medical Services, Inc | Internal Medicine | 2267 Lava Ridge Ct, Roseville, CA 95661-3062 | 2019-11-25 |
| 1912228743 | Clifford L Weldon M D P L C | Internal Medicine | 30695 Little Mack Ave Ste 500, Roseville, MI 48066-1772 | 2010-06-16 |
| 1811190713 | Reetu Sharma | Internal Medicine | 2 Medical Plaza Drive, 175, Roseville, CA 95661-3049 | 2007-06-07 |
| 1306948435 | Mukhtar Ahmad Khan | Internal Medicine | 25779 Kelly Rd, Suite C, Roseville, MI 48066-4973 | 2006-09-01 |
| 1134144017 | Madjid Mesgarzadeh | Internal Medicine | 25910 Kelly Rd, Suite B, Roseville, MI 48066-4466 | 2006-07-13 |
| 1194714980 | St Clair Cardiovascular Surgeons Plc | Internal Medicine | 25599 Kelly Rd, Ste A, Roseville, MI 48066-4975 | 2005-10-14 |
| 1689676223 | Luis Antonio Pires | Internal Medicine | 25195 Kelly Rd, Suite A, Roseville, MI 48066-4909 | 2005-08-12 |
| 1336141977 | Narayanan Vikraman | Internal Medicine | 18325 E 10 Mile Rd, Suite 400, Roseville, MI 48066-4990 | 2005-08-12 |
| 1255337689 | Joel C Engel | Internal Medicine | 18303 E 10 Mile Rd, Suite 100, Roseville, MI 48066-4988 | 2005-06-21 |
| 1194729053 | Douglas R Moore | Internal Medicine | 25195 Kelly Rd Ste A, Roseville, MI 48066-4909 | 2005-06-09 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.