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EVOLVE RESTORATIVE CENTER
NPI 1215437249
Pain Medicine - Interventional Pain Medicine in Santa Rosa, CA

Active since February 16, 2018CLIA 05D2172616 · Accreditation
220 CONCOURSE BLVD, SANTA ROSA, CA 95403(844) 527-7369(844) 847-4943 Get Directions Write a Review

NPPES record last updated: June 12, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 12, 2025, Apr 11, 2024, Jul 14, 2023 and 2 more (5 updates tracked since 2018).

About Evolve Restorative Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVOLVE RESTORATIVE CENTER (NPI 1215437249) is a healthcare organization registered as an interventional pain medicine in Santa Rosa, California and active in the NPI registry since February 2018. The organization holds an CLIA Accreditation certificate valid through July 14, 2028, maintains 2 additional practice locations, and lists Eric Bruntlett, Coo, as its authorized official.

NPPES Registry Identity

NPI1215437249
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NameEVOLVE RESTORATIVE CENTER
Location Address220 CONCOURSE BLVDSanta Rosa, CA 95403-8210
Mailing Address220 Concourse BlvdSanta Rosa, CA 95403-8210 · (844) 527-7369 · Fax (844) 847-4943
Phone(844) 527-7369
Fax(844) 847-4943
Organization SubpartNo
Authorized OfficialEric BruntlettCoo · (707) 495-9632
Enumeration DateFebruary 16, 2018
Last NPPES UpdateJune 12, 20255 updates tracked since enumeration
NPPES CertifiedJune 12, 2025
✔ NPI 1215437249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
Definition
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
220 CONCOURSE BLVD, Santa Rosa, CA 95403
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Secondary Practice Locations 2

Location 1181 Andrieux St Ste 107Sonoma, CA 95476-6920 · Phone (844) 527-7369 · Fax (844) 847-4943
Location 25150 Hill Rd E Ste CLakeport, CA 95453-5100 · Phone (844) 527-7369 · Fax (844) 847-4943

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evolve Restorative Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Evolve Restorative Center, which bills Medicare for the services they deliver. Of these, 6 practice at this address. They are listed nearest first.

Clinicians, nearest first (9)

Ramneek Dhillon, MD, MSC
Pain Management
NPI 1285261974
220 CONCOURSE BLVD
Santa Rosa, CA 95403
(844) 527-7369
✔ PECOS✔ Accepts MedicareSame address
Jeremy Fuller, NP-C
Nurse Practitioner
NPI 1285221440
220 CONCOURSE BLVD
Santa Rosa, CA 95403
(844) 527-7369
✔ PECOS✔ Accepts MedicareSame address
Julie Landecker, DPT
Physical Therapist in Private Practice
NPI 1780647693
220 CONCOURSE BLVD
Santa Rosa, CA 95403
(844) 527-7369
✔ Accepts MedicareSame address
Anna Mitsunaga, PT DPT
Physical Therapist in Private Practice
NPI 1851506547
220 CONCOURSE BLVD
Santa Rosa, CA 95403
(844) 527-7369
✔ Accepts MedicareSame address
Jason Pope, MD
Pain Management
NPI 1215078647
220 CONCOURSE BLVD
Santa Rosa, CA 95403
(844) 527-7369
✔ PECOS✔ Accepts MedicareSame address
Anal Shah, DPT
Physical Therapist in Private Practice
NPI 1669920203
220 CONCOURSE BLVD
Santa Rosa, CA 95403
(844) 527-7369
✔ Accepts MedicareSame address
Holly Mcclure, NP
Nurse Practitioner
NPI 1023424348
5789 STATE FARM DR STE 110
Rohnert Park, CA 94928
(707) 615-3347
✔ PECOS✔ Accepts Medicare12 mi
Linda Dashiell, FNP-C CNM
Nurse Practitioner
NPI 1699777508
5150 HILL RD E STE C
Lakeport, CA 95453
(844) 527-7369
✔ PECOS✔ Accepts Medicare41 mi
Chau Vu, MD
Pain Management
NPI 1538508841
625 S FAIR OAKS AVE STE 230
Pasadena, CA 91105
(626) 469-2939
✔ PECOS✔ Accepts Medicare398 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 05D2172616

Evolve Restorative Center · Santa Rosa, CA
Active · expires Jul 14, 2028
CLIA Number05D2172616
Laboratory TypePhysician Office
Certificate Effective DateJuly 15, 2026
Certificate Expiration DateJuly 14, 2028
Laboratory DirectorDr. Kim Janatpour
Laboratory Phone(844) 527-7369
Laboratory LocationEvolve Restorative Center220 Concourse Blvd, Santa Rosa, CA 95403
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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 Evolve Restorative Center's NPI number?

The NPI number for Evolve Restorative Center is 1215437249. It was assigned to this organization in the NPPES registry on February 16, 2018.

Where is Evolve Restorative Center located?

Evolve Restorative Center is located at 220 Concourse Blvd, Santa Rosa, CA 95403. The listed phone number is (844) 527-7369.

What is Evolve Restorative Center's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Evolve Restorative Center enrolled in Medicare?

Yes. Evolve Restorative Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Evolve Restorative Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 3 Medicare specialties reassign their Medicare billing to Evolve Restorative Center. A 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 the clinician's services. The largest specialties are Nurse Practitioner (3), Pain Management (3) and Physical Therapist in Private Practice (3). Of these, 6 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Evolve Restorative Center hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 05D2172616) is associated with this NPI, valid through July 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Evolve Restorative Center was last updated on June 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.