NPIMap

Individual provider Active NPI

Rajesh K Ranadive, MD

  • Internal Medicine Physician
  • Petaluma, CA
National Provider Identifier
1497704522
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A84630 Issued in CA
Practice address
141 Lynch Creek Way Ste C
Petaluma, CA 94954-2390
Phone
(707) 763-0802
Fax
(707) 763-0803
NPI assigned
May 8, 2006
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A84630 CA Primary

Addresses

Primary practice location

141 Lynch Creek Way Ste C
Petaluma, CA 94954-2390

Mailing address

141 Lynch Creek Way Ste C
Petaluma, CA 94954-2390
Phone (707) 763-0802

Other identifiers 1

IdentifierTypeStateIssuer
00A846300MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rranadive1658190@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202001099 CA Practitioner - Internal Medicine 4385537604 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Veterans Home of CaliforniaGroup PAC ID 5799683827, 25 clinicians

Practice addresses (Care Compare)

100 California Dr
Yountville, CA 94599-1411
Phone (707) 944-4506

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Veterans Home of California CurrentSince Sep 2, 2025 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Aug 29, 2025 Accepting new patients
Santa Rosa Community Health Centers Current Accepting new patients
Veterans Home of California Current Accepting new patients
Veterans Home of California CurrentSince Sep 2, 2025 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Aug 29, 2025 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine Past Accepting new patients

Locations

1227 O St
Rm 402
Sacramento, CA 95814

3569 Round Barn Cir
Santa Rosa, CA 95403

100 California Dr
Yountville, CA 94599
Phone (707) 944-4506

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1497704522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 LYNCH CREEK WAY STE C",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542390",
            "telephone_number": "707-763-0802",
            "fax_number": "707-763-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 LYNCH CREEK WAY STE C",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542390",
            "telephone_number": "707-763-0802",
            "fax_number": "707-763-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANADIVE",
        "first_name": "RAJESH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A84630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A846300",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rranadive1658190@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "905 E Washington St",
            "city": "Petaluma",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949523389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.