Kelly Pfeifer, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A66577 Issued in CA

Practice address

1301 Southpoint Blvd
Petaluma, CA 94954-6858

Phone

(707) 559-7500

Fax

(707) 559-7570

NPI assigned

Aug 18, 2005

Sex

Female

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 5

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.pfeifer@332828990373892.direct.elationemr.com

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.

• University of California SFGH Medical Group

  • Anesthesiology Physician
  • San Francisco, CA
  • NPI 1366417420
  Medicare reassignment NPD
• University of California SFGH Medical Group

  • Vascular Surgery Physician
  • San Francisco, CA
  • NPI 1033913959
  NPD
• University of California SFGH Medical Group

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1174598296
  NPD
• Petaluma Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Petaluma, CA
  • NPI 1588656268
  NPD (past)
• Quantum Healthcare Medical Associates Inc.

  • Hospitalist Physician
  • Colton, CA
  • NPI 1568490597

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1083606776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SOUTHPOINT BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546858",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SOUTHPOINT BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546858",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFER",
        "first_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A66577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP70696F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ISSUER MEDICARE",
            "identifier": "ZZZ18742Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70696F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A66577",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BCP70696F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Petalumaidence Opco, LLC
• Antoinette Louise Petersen
• Thomas Peterson
• Krista Joy Lennice Peyton, PA-C
• Megan Alyce Pfeffer
• Trinique Pham, PT, DPT
• Christine Jia En Phang
• Amariah Winter Phillips-Arterburn
• Dale B Phillips, RPT
• Gabriella Bristol Phillips

• Family Medicine Physician in Petaluma, CA
• Providers in Petaluma, 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 Dec 17, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.