Charles Robert Pettit, M.D.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

A235594 Issued in CA

Practice address

181 Andrieux St Ste 106
Sonoma, CA 95476-6920

Phone

(707) 931-6485

Fax

(707) 581-1766

NPI assigned

Feb 21, 2007

Sex

Male

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

Specialty

Otolaryngology

Education

University of California, Irvine, California College of Medicine, 1968

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Charles Robert Pettit MD a Medical Corporation

  • Otolaryngology/Facial Plastic Surgery Physician
  • Santa Rosa, CA
  • NPI 1316268386
  Medicare reassignment Authorized official
• North Sonoma County Health Care District

  • Medicare Defined Swing Bed Hospital Unit
  • Healdsburg, CA
  • NPI 1043308539
  NPD (past)

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

• Community Hospital of the Monterey Peninsula

  • Psychiatric Hospital Unit
  • Monterey, CA
  • NPI 1679562169
  Care Compare affiliation
• Community Hospital of the Monterey Peninsula

  • General Acute Care Hospital
  • Monterey, CA
  • NPI 1932197258
  Care Compare affiliation

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1326183583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4489",
            "city": "CARMEL",
            "state": "CA",
            "postal_code": "939214489",
            "telephone_number": "707-931-6485",
            "fax_number": "707-581-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 ANDRIEUX ST STE 106",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766920",
            "telephone_number": "707-931-6485",
            "fax_number": "707-581-1766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Cass St",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939402904",
            "country_code": "US",
            "telephone_number": "707-931-6485",
            "fax_number": "707-581-1766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "CHARLES",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "A235594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Vernon Perryman, M.D.
• Personal Hearing Solutions
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• Carole Marie Petersen, LCSW
• Robert T Petty, DO
• Pharmaca Integrative Pharmacy, Inc.
• Hannah Elizabeth Philbin, LMFT, LPCC
• Peter Emmett Philbin, MD
• Melinda L Phoenix, L.AC

• Otolaryngology/Facial Plastic Surgery Physician in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.