Faye Susan Lundergan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A76943 Issued in CA

Practice address

1456 Professional Dr Ste 405
Petaluma, CA 94954

Phone

(707) 769-7500

Fax

(707) 769-7570

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: flundergan65068@direct-ucsfmedicalcenter.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.

• Regents Univ of California UCSF

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1124439807

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1174554240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 PROFESSIONAL DR",
            "address_2": "STE 405",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-769-7500",
            "fax_number": "707-769-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 PROFESSIONAL DR STE 405",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-769-7500",
            "fax_number": "707-769-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDERGAN",
        "first_name": "FAYE",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A76943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breena Luber
• Randall Carl Lucas, TECHNICIAN
• Lucky Stores II LLC
• Maya Lujan, PH.D.
• Christel F Lukoff, PH.D. MFT
• Teresa Lynn Lurie, NP
• Luxottica of America Inc.
• Laura Lyons, AMFT
• Roxanne Macaraeg
• Dominique Therese Maccurtin, LMFT

• Pediatrics Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.