Santa Rosa Sports Medicine, Incorporated
NPI 1952555740 · Sports Medicine (Family Medicine) Physician · Santa Rosa, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Santa Rosa Sports Medicine, Incorporated is a Sports Medicine (Family Medicine) Physician organization in Santa Rosa, CA (NPI 1952555740).
Provider details
- NPI number
- 1952555740
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ty Affleck, President(707) 546-9400
- License
- G073843 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Santa Rosa Sports and Family Medicine
Registry dates
- Enumerated
- 2008-11-06
- Last updated
- 2014-10-13
Frequently asked questions
- What is Santa Rosa Sports Medicine, Incorporated's NPI number?
- Santa Rosa Sports Medicine, Incorporated's National Provider Identifier (NPI) is 1952555740, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Santa Rosa Sports Medicine, Incorporated?
- Santa Rosa Sports Medicine, Incorporated is classified in the NPPES registry as Sports Medicine (Family Medicine) Physician (Allopathic & Osteopathic Physicians).
- Where is Santa Rosa Sports Medicine, Incorporated located?
- Santa Rosa Sports Medicine, Incorporated's practice location on file with NPPES is 1255 N Dutton Ave, Santa Rosa, CA 95401-4663.
- What is Santa Rosa Sports Medicine, Incorporated's phone number?
- The practice phone number listed in the NPPES registry for Santa Rosa Sports Medicine, Incorporated is (707) 546-9400.
- Does Santa Rosa Sports Medicine, Incorporated accept Medicare?
- Santa Rosa Sports Medicine, Incorporated is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Santa Rosa Sports Medicine, Incorporated?
- The authorized official listed on Santa Rosa Sports Medicine, Incorporated's NPPES record is Ty Affleck, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Santa Rosa Sports Medicine, Incorporated's NPI active?
- Yes — Santa Rosa Sports Medicine, Incorporated's NPI (1952555740) is active in the NPPES registry as of the last update on 2014-10-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.