MRS. BREANNA TETREAULT DO
NPI 1164085536
Family Medicine in Berkeley, CA
About Mrs. Breanna Tetreault Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. BREANNA TETREAULT DO (NPI 1164085536) is an individual family medicine provider in Berkeley, California, licensed in California (20A20241) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Santa Rosa, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Breanna Tetreault Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Breanna Tetreault reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Walnut Creek, CA 94597
- Reassigned Medicare billing, California enrollment
- 650 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94702 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BERKELEY, CA 94702
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Breanna Tetreault's NPI number?
The NPI number for Breanna Tetreault is 1164085536. It was assigned to this individual provider in the NPPES registry on April 20, 2019.
Where is Breanna Tetreault located?
Breanna Tetreault practices at 3100 San Pablo Ave Ste 310, Berkeley, CA 94702. The listed phone number is (510) 985-5000.
What is Breanna Tetreault's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Breanna Tetreault enrolled in Medicare?
Yes. Breanna Tetreault is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Breanna Tetreault's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Breanna Tetreault reassigns Medicare benefits to John Muir Physician Network (Walnut Creek, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Breanna Tetreault's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Breanna Tetreault was last updated on September 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Breanna Tetreault, DO · NPI 1164085536
Family Medicine physician in Berkeley, California. Individual provider, active in the CMS NPPES registry since April 20, 2019.
## Identity
- **NPI:** 1164085536 (Entity type: Individual)
- **Enumerated:** April 20, 2019
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 20A20241 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3100 SAN PABLO AVE STE 310, Berkeley, CA 94702-2498
- **Phone:** (510) 985-5000 · **Fax:** (510) 985-5002
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** John Muir Physician Network (NPI 1841407665, Walnut Creek, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** September 22, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1164085536) · Data from the CMS NPPES public registry.