Nurit Licht, M.D.
Individual provider Active NPI Family Medicine Physician · Novato, CA
NPI 1477545176 · NPPES record last updated Dec 9, 2025
Key facts
- NPI
- 1477545176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A90977 (CA)
- Practice address
- 75 Rowland Way Ste 200
Novato, CA 94945-5054 - Phone
- (415) 897-9664
- Fax
- (415) 897-2446
- NPI assigned
- Aug 18, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 4
Owned or controlled facilities with NPI records 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Geisel School of Medicine at Dartmouth, 1999
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Petaluma Health Center Inc
Regents Univ of California UCSF
Practice addresses (Care Compare)
1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500
505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000
Hospital & facility affiliations
- Sutter Care at Home
- Marinhealth Medical Center
- Novato Community Hospital
- Petaluma Valley Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Petaluma Health Center Inc |
Federally qualified health center | Corporate Officer Operational/Managerial Control |
Feb 19, 2015 Aug 29, 2014 |
| Rohnert Park Health Center |
Federally qualified health center | Corporate Officer (20%) W-2 Managing Employee (20%) |
Jan 1, 2014 Jan 29, 2016 |
| Petaluma Eye Care |
Federally qualified health center | Corporate Officer (5%) W-2 Managing Employee (5%) |
Aug 3, 2015 Aug 29, 2005 |
| Mary Isaak Center Clinic |
Federally qualified health center | Corporate Officer (5%) W-2 Managing Employee (5%) |
Aug 3, 2015 Aug 29, 2005 |
| San Antonio High School Health Clinic |
Federally qualified health center | Corporate Officer (5%) W-2 Managing Employee (5%) |
Aug 3, 2015 Aug 29, 2005 |
| Casa Grande High School Health Clinic |
Federally qualified health center | Corporate Officer (5%) W-2 Managing Employee (5%) |
Aug 3, 2015 Aug 29, 2005 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071215000209 | CA | Practitioner - Family Practice | 6709976616 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90977 | CA | MD | Pharmacist |
| A90977 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents Univ of California UCSF | Current |
Accepting new patients | |
| Petaluma Health Center Inc | Current |
Accepting new patients | |
| Petaluma Health Center, Inc | Current |
Accepting new patients | |
| Community Health Care | Past | Accepting new patients | |
| Petaluma Health Center Inc | Past | Accepting new patients | |
| One Medical Group, Inc. | Family Medicine | Past | Accepting new patients |
Locations
75 Rowland Way
Ste 200
Novato, CA 94945
Phone (415) 897-3174
75 Rowland Way
Novato, CA 94945
Phone (415) 897-9664
1179 N McDowell Blvd
Petaluma, CA 94954
505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058
4000 Civic Center Dr
San Rafael, CA 94903
Phone (415) 492-3333
4000 Civic Center Dr
Ste 206
San Rafael, CA 94903
Phone (415) 492-4800
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HEDCAA
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A90977 | CA | Yes |
Addresses
Primary practice location
75 Rowland Way Ste 200
Novato, CA 94945-5054
Mailing address
75 Rowland Way Ste 200
Novato, CA 94945-5054
Phone (415) 897-9664
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ18742Z | Other | CA | ISSUER MEDICARE |
| A90977 | Other | CA | LICENSE NUMBER |
| FHC70696F | Medicaid | CA | |
| 1477545176 | Medicaid | CA | |
| HAP70696F | Medicaid | CA | |
| BCP70696F | Medicaid | CA |
NPI Registry JSON
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765238400000",
"number": "1477545176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 ROWLAND WAY STE 200",
"city": "NOVATO",
"state": "CA",
"postal_code": "949455054",
"telephone_number": "415-897-9664",
"fax_number": "415-897-2446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 ROWLAND WAY STE 200",
"city": "NOVATO",
"state": "CA",
"postal_code": "949455054",
"telephone_number": "415-897-9664",
"fax_number": "415-897-2446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICHT",
"first_name": "NURIT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-18",
"last_updated": "2025-12-09",
"certification_date": "2025-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A90977",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ISSUER MEDICARE",
"identifier": "ZZZ18742Z",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "A90977",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC70696F",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1477545176",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HAP70696F",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "BCP70696F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Novato, CA
- Harvey Arthur Lerchin
- Tobi Lessem
- Jonathan Michael Levin
- Magdalena Levin
- Sandra P. Levy
- Saundra Ann Lieberman
- Andrea E Lieberstein
- Lifecare Solutions Inc
- Lifelong Medical Care
- Luis Ramon Limchayseng
All providers in Novato, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.