Amy C. Kaelin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A78541 Issued in CA

Practice address

205 Stowring Rd
Petaluma, CA 94952-1056

Phone

(707) 792-6743

Fax

(707) 792-6743

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447372800000",
    "number": "1336223320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 STOWRING RD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949521056",
            "telephone_number": "707-792-6743",
            "fax_number": "707-792-6743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 STOWRING RD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949521056",
            "telephone_number": "707-792-6743",
            "fax_number": "707-792-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAELIN",
        "first_name": "AMY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A785410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J. David Judge, MD
• Julie Clark, M.D., Inc
• Sarah Jung
• Jurina Smida DDS
• Devi Kabaleeswaran
• Kasena Kafka, M.A., CCC-SLP
• Kaiser Foundation Health Plan Inc
• Jennifer Kalkowski
• Amina Kamal
• Caroline Kane, NBC-HWC

• Internal Medicine Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.