Individual provider Active NPI

Cecelia Rondou, FNP, CNM

  • Midwife
  • Santa Rosa, CA
National Provider Identifier
1285950147
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
1377 Issued in CA
Practice address
990 Sonoma Ave Ste 18
Santa Rosa, CA 95404-4813
Phone
(707) 579-1102
Fax
(707) 579-1386
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 391135 CA
Midwife 176B00000X 1377 CA Primary

Addresses

Primary practice location

990 Sonoma Ave Ste 18
Santa Rosa, CA 95404-4813

Mailing address

990 Sonoma Ave Ste 18
Santa Rosa, CA 95404-4813
Phone (707) 579-1102

Other identifiers 1

IdentifierTypeStateIssuer
P01437995OtherCARAILROAD MEDICARE

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141210002262 CA Practitioner - Certified Nurse Midwife (CNM) 1355663964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
391135CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Oct 1, 2022 Accepting new patients
Providence Medical Foundation CurrentSince Oct 1, 2022 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Khawaja MD Inc CurrentSince Aug 12, 2020 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

500 Doyle Park Dr
Ste 200
Santa Rosa, CA 95405
Phone (707) 303-1719

500 Doyle Park Dr
Ste 103
Santa Rosa, CA 95405
Phone (707) 303-8330

500 Doyle Park Dr
Santa Rosa, CA 95405
Phone (707) 528-1050

990 Sonoma Ave
Ste 18
Santa Rosa, CA 95404
Phone (707) 575-9009

Interoperability endpoints

  • Direct secure messaging: crondou1658217@oc.providencedirect.org
  • Direct secure messaging: crondou208932@hisp.ehr.sutterhealth.org

Organizations & group practices 8

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 1

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": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1285950147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SONOMA AVE STE 18",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044813",
            "telephone_number": "707-579-1102",
            "fax_number": "707-579-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SONOMA AVE STE 18",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044813",
            "telephone_number": "707-579-1102",
            "fax_number": "707-579-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDOU",
        "first_name": "CECELIA",
        "credential": "FNP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "391135",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "1377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01437995",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.