Individual provider Active NPI

Jon Sterngold, MD

  • General Practice Physician
  • Santa Rosa, CA
National Provider Identifier
1265664866
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G27300 Issued in CA
Practice address
1287 Fulton Rd
Santa Rosa, CA 95401-4923
Phone
(707) 595-3133
NPI assigned
Aug 14, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G27300 CA Primary
General Practice Physician 208D00000X GFE27300 CA

Addresses

Primary practice location

1287 Fulton Rd
Santa Rosa, CA 95401-4923

Mailing address

PO Box 1770
La Mesa, CA 91944-1770
Phone (619) 464-1165

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130816000612 CA Practitioner - General Practice 5991947129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Stanford University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jon Sterngold MD Inc a Professional CorporationGroup PAC ID 9436412954, 5 clinicians

Practice addresses (Care Compare)

1287 Fulton Rd
Santa Rosa, CA 95401-4923
Phone (707) 595-3133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GFE27300CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jon Sterngold MD Inc a Professional Corporation CurrentSince Mar 12, 2018 Accepting new patients

Locations

1400 Expo Pkwy
Sacramento, CA 95815
Phone (661) 398-1800

1287 Fulton Rd
Santa Rosa, CA 95401
Phone (707) 543-2031

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1265664866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "619-464-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 FULTON RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014923",
            "telephone_number": "707-595-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERNGOLD",
        "first_name": "JON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-14",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G27300",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "GFE27300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.