Santa Rosa Sports Medicine, Incorporated
NPI 1952555740ActiveOrganization· Family Medicine, Sports Medicine· Santa Rosa, CA
Family Medicine, Sports Medicine in Santa Rosa, California, registered in NPPES in November 2008. The authorized official on file is Ty Preston Affleck, M.D., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1952555740 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 6, 2008 |
| Last updated in NPPES | Oct 13, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine, Sports Medicine Primary | 207QS0010X | G073843 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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