Individual provider Active NPI

Olena Kotova Lineberry, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Placerville, CA
National Provider Identifier
1093987364
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A129184 Issued in CA
Practice address
1004 Fowler Way Ste 4
Placerville, CA 95667-5746
Phone
(530) 626-9488
NPI assigned
Mar 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A129184 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A129184 CA Primary

Addresses

Primary practice location

1004 Fowler Way Ste 4
Placerville, CA 95667-5746

Mailing address

PO Box 45680 Physician Support Services
San Francisco, CA 94145-7956
Phone (530) 626-2787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MI, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20141021000105 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 2264699057 Reassigns benefits to 6 organizations
I20230817002152 MI Practitioner - Critical Care (Intensivists) 2264699057 Reassigns benefits to 1 organization
I20231011000314 TX Practitioner - Critical Care (Intensivists) 2264699057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians
Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians
Veeone Medical Group II Professional CorporationGroup PAC ID 8820468143, 7 clinicians

Practice addresses (Care Compare)

1000 Nut Tree Rd
Vacaville, CA 95687-4100
Phone (707) 646-7000

1010 Nut Tree Rd
Suite 100B and 200
Vacaville, CA 95687-4172
Phone (707) 646-7999

1020 Nut Tree Rd
Vacaville, CA 95687-4100

1095 Marshall Way
Suite 100
Placerville, CA 95667-5722
Phone (530) 626-2920

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 646-5000

1860 Pennsylvania Ave
Suite 200
Fairfield, CA 94533-3550
Phone (707) 646-4180

5001 Auburn Folsom Rd
Loomis, CA 95650-9420
Phone (916) 865-4668

Hospital & facility affiliations

  • Marshall Medical Center Hospital, Placerville, CA, CCN 050254
  • Northbay Medical Center Hospital, Fairfield, CA, CCN 050367
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
  • Banner Heart Hospital Hospital, Mesa, AZ, CCN 030105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
129184CAMDClinical Social Worker
A129184CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Dec 1, 2020 Accepting new patients
Marshall Medical Center CurrentSince Oct 1, 2018 Accepting new patients
Veeone Medical Group PA Critical Care Medicine CurrentSince Oct 1, 2022 Accepting new patients
Marshall Medical Center CurrentSince Oct 1, 2018 Accepting new patients
Ccmma Ca PC Critical Care Medicine CurrentSince Jul 1, 2025 Accepting new patients
Veeone Medical Group II Professional Corporation Critical Care Medicine CurrentSince Nov 8, 2022 Accepting new patients
Northbay Healthcare Group CurrentSince Dec 1, 2020 Accepting new patients
Northbay Health Medical Foundation Pulmonary Disease CurrentSince Jan 1, 2026 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
Wellstar Cardiovascular Medicine, LLC PastSince May 1, 2020 Accepting new patients
Aminia Physicians Group PLLC Past Accepting new patients

Locations

3800 Janes Rd
Arcata, CA 95521
Phone (707) 822-3621

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

1860 Pennsylvania Ave
Ste 200
Fairfield, CA 94533
Phone (707) 427-5211

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1095 Marshall Way
Ste 100
Placerville, CA 95667
Phone (530) 344-5470

1004 Fowler Way
Ste 4
Placerville, CA 95667
Phone (530) 626-9488

1095 Marshall Way
Ste 201
Placerville, CA 95667
Phone (530) 344-5470

1100 Marshall Way
Placerville, CA 95667
Phone (530) 626-2601

1420 E Roseville Pkwy
Ste 140
Roseville, CA 95661

1420 E Roseville Pkwy
Ste 140519
Roseville, CA 95661

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

1010 Nut Tree Rd
Ste 100
Vacaville, CA 95687
Phone (707) 333-3065

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

1010 Nut Tree Rd
Ste 100B
Vacaville, CA 95687
Phone (707) 646-7999

101 Main St
Winters, CA 95694
Phone (530) 795-4123

444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256

11111 Katy Fwy
Ste 910
Houston, TX 77079
Phone (646) 687-4629

Organizations & group practices 11

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1093987364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680 PHYSICIAN SUPPORT SERVICES",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941457956",
            "telephone_number": "530-626-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 FOWLER WAY STE 4",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675746",
            "telephone_number": "530-626-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINEBERRY",
        "first_name": "OLENA",
        "middle_name": "KOTOVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A129184",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A129184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.