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BRADLEY GARRETT FISTONICH DO
NPI 1548062896
Student in an Organized Health Care Education/Training Program in Sacramento, CA

Active since March 26, 2025PECOS Enrolled
7601 HOSPITAL DR STE 103, SACRAMENTO, CA 95823(916) 681-1600 Get Directions Write a Review

NPPES record last updated: March 26, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bradley Garrett Fistonich Do NPPES

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

BRADLEY GARRETT FISTONICH DO (NPI 1548062896) is an individual student in an organized health care education/training program in Sacramento, California and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548062896
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBRADLEY GARRETT FISTONICHCredential: DO
Location Address7601 HOSPITAL DR STE 103Sacramento, CA 95823-5408
Mailing Address7601 Hospital Dr Ste 103Sacramento, CA 95823-5408 · (916) 681-1600
Phone(916) 681-1600
Sole ProprietorNo
Enumeration DateMarch 26, 2025
NPPES CertifiedMarch 26, 2025
✔ NPI 1548062896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
7601 HOSPITAL DR STE 103, Sacramento, CA 95823
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradley Garrett Fistonich Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHIRLEY KIM
Student in an Organized Health Care Education/Training Program
7601 HOSPITAL DR STE 103
SACRAMENTO, CA 95823
Sacramento County (916) 681-1600
LAURA DUONG MD
Family Medicine
7601 HOSPITAL DR STE 103
SACRAMENTO, CA 95823
Sacramento County (916) 681-1600
LAETICIA CAMPBELL MD
Student in an Organized Health Care Education/Training Program
7601 HOSPITAL DR STE 103
SACRAMENTO, CA 95823
Sacramento County (916) 681-1600
MS. DESIREE ROXANN ACOSTA MD
Student in an Organized Health Care Education/Training Program
7601 HOSPITAL DR STE 103
SACRAMENTO, CA 95823
Sacramento County (916) 681-3456
PRANITHA PRASAD
Student in an Organized Health Care Education/Training Program
7601 HOSPITAL DR STE 103
SACRAMENTO, CA 95823
Sacramento County (916) 681-1600
DEVERY E MITCHELL MD
Family Medicine
7601 HOSPITAL DR STE 103
SACRAMENTO, CA 95823
Sacramento County (916) 681-1600
KARINA SALAZAR GOOKIN M.D.
Family Medicine
7601 HOSPITAL DR STE 103
SACRAMENTO, CA 95823
Sacramento County (916) 681-1600
DR. ZAHEER ISLAM SALAM DO
Student in an Organized Health Care Education/Training Program
7601 HOSPITAL DR STE 103
SACRAMENTO, CA 95823
Sacramento County (916) 681-1600

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 Bradley Fistonich's NPI number?

The NPI number for Bradley Fistonich is 1548062896. It was assigned to this individual provider in the NPPES registry on March 26, 2025.

Where is Bradley Fistonich located?

Bradley Fistonich practices at 7601 Hospital Dr Ste 103, Sacramento, CA 95823. The listed phone number is (916) 681-1600.

What is Bradley Fistonich's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Bradley Fistonich enrolled in Medicare?

Yes. Bradley Fistonich is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bradley Fistonich was last updated on March 26, 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.