Michael D. Maggioncalda, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6628 Issued in CA

Practice address

5900 State Farm Dr
Rohnert Park, CA 94928-2149

Phone

(707) 206-3000

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

Philadelphia College of Osteopathic Medicine, 1990

Medicare assignment

May accept Medicare assignment

Group practices

Sonoma Valley Community Health CenterGroup PAC ID 6800708686, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sonoma Valley Hospital Hospital, Sonoma, CA, CCN 050090

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmaggioncalda627347@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sonoma Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sonoma, CA
  • NPI 1770669715
  Medicare reassignment Care Compare group NPD
• Prima Medical Foundation

  • Clinic/Center
  • Novato, CA
  • NPI 1811217946
  NPD (past)
• Prima Medical Group, Inc.

  • Family Medicine Physician
  • San Rafael, CA
  • NPI 1154377489
  NPD (past)
• Sonoma Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sonoma, CA
  • NPI 1427118942
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sonoma Valley Health Care District

  • General Acute Care Hospital
  • Sonoma, CA
  • NPI 1710063870
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1043394042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 STATE FARM DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282149",
            "telephone_number": "707-206-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGIONCALDA",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX66280",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5900 State Farm Dr",
            "city": "Rohnert Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949282149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Arthur C Luethe, D.C.
• Poonlarp Lurslurchachai
• Wichika Te Ly
• Lyndsey Rose Lynch
• Elyse Mager, BCBA
• Joshua A Magly
• Venus Ann Maher, D.C.
• Audrey Mahlstedt, MA CCC-SLP
• Leah Mahood
• George Malkemus, DDS

• Family Medicine Physician in Rohnert Park, CA
• Providers in Rohnert Park, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.