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BOZUK & ASSOCIATES SURGICAL, INC.
NPI 1609912914
Surgery in Petaluma, CA

Active since January 30, 2007
1456 PROFESSIONAL DR, STE. #404, PETALUMA, CA 94954(707) 763-3967(707) 765-0554 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Bozuk & Associates Surgical, Inc. NPPES

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

BOZUK & ASSOCIATES SURGICAL, INC. (NPI 1609912914) is a healthcare organization registered as a surgery in Petaluma, California and active in the NPI registry since January 2007. The organization lists Michael Ivan Bozuk, Physician, as its authorized official.

NPPES Registry Identity

NPI1609912914
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameBOZUK & ASSOCIATES SURGICAL, INC.
Location Address1456 PROFESSIONAL DR, STE. #404Petaluma, CA 94954-6639
Mailing Address1456 Professional Dr, Ste. #404Petaluma, CA 94954-6639 · (707) 763-3967 · Fax (707) 765-0554
Phone(707) 763-3967
Fax(707) 765-0554
Organization SubpartNo
Authorized OfficialMichael Ivan BozukPhysician · (707) 763-3967
Enumeration DateJanuary 30, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1609912914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in CA · A73703
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
1456 PROFESSIONAL DR, Petaluma, CA 94954
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Other Identifiers 1

Medicaid00A737030CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bozuk & Associates Surgical, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20051220000639Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Bozuk & Associates Surgical, Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Michael Bozuk, M.D.
General Surgery
NPI 1700800604
3835 CYPRESS DR STE 202
Petaluma, CA 94954
(707) 763-3967
✔ PECOS✔ Accepts Medicare3.0 mi

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

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 Bozuk & Associates Surgical, Inc.'s NPI number?

The NPI number for Bozuk & Associates Surgical, Inc. is 1609912914. It was assigned to this organization in the NPPES registry on January 30, 2007.

Where is Bozuk & Associates Surgical, Inc. located?

Bozuk & Associates Surgical, Inc. is located at 1456 Professional Dr Ste. #404, Petaluma, CA 94954. The listed phone number is (707) 763-3967.

What is Bozuk & Associates Surgical, Inc.'s specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Bozuk & Associates Surgical, Inc. enrolled in Medicare?

Yes. Bozuk & Associates Surgical, Inc. is registered in the Medicare PECOS enrollment system.

When is Bozuk & Associates Surgical, Inc.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Bozuk & Associates Surgical, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Surgery) reassigns their Medicare billing to Bozuk & Associates Surgical, Inc.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bozuk & Associates Surgical, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.