Individual provider Active NPI

Madison Nichole Yungert

  • Pediatrics Physician
  • Santa Rosa, CA
National Provider Identifier
1386481265
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
95032719 Issued in CA
Practice address
711 Stony Point Rd Ste 17
Santa Rosa, CA 95407-6848
Phone
(707) 303-3600
NPI assigned
Jul 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 95032719 CA Primary

Addresses

Primary practice location

711 Stony Point Rd Ste 17
Santa Rosa, CA 95407-6848

Mailing address

351 Wilson St
Petaluma, CA 94952-3141
Phone (209) 631-5208

Other names 1

  • Madison Nichole Foss Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250115003343 CA Practitioner - Nurse Practitioner 5395273569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95032719CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers Current Accepting new patients
Santa Rosa Community Health Centers CurrentSince Oct 28, 2024 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Oct 28, 2024 Accepting new patients
Santa Rosa Community Health Centers PastSince Jul 22, 2025 Accepting new patients
Santa Rosa Community Health Centers PastSince Jul 9, 2025 Accepting new patients
Providence Medical Foundation PastSince Jul 9, 2025 Accepting new patients

Locations

1300 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 303-3395

3569 Round Barn Cir
Santa Rosa, CA 95403

Organizations & group practices 6

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": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1386481265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 WILSON ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523141",
            "telephone_number": "209-631-5208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 STONY POINT RD STE 17",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076848",
            "telephone_number": "707-303-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUNGERT",
        "first_name": "MADISON",
        "middle_name": "NICHOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "95032719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "FOSS",
            "middle_name": "NICHOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.