Robert T Petty, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DO00001542 Issued in WA

Practice address

866 Donner Ave
Sonoma, CA 95476-7136

Phone

(360) 708-7940

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Sonoma Valley Emergency Physicians Medical Group, Inc

  • Emergency Medicine Physician
  • Sonoma, CA
  • NPI 1710164629
  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Roseville, CA
  • NPI 1346265154
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Central California Faculty Medical Group, Inc.

  • Internal Medicine Physician
  • Clovis, CA
  • NPI 1992742852
  NPD (past)
• Central California Radiology Associates Inc

  • Diagnostic Radiology Physician
  • Visalia, CA
  • NPI 1619343050
  NPD (past)
• Sierra Rural Physicians, Inc.

  • Emergency Medicine Physician
  • Mariposa, CA
  • NPI 1699890905
  NPD (past)
• Stanley Y. Louie DO, Inc

  • Family Medicine Physician
  • Selma, CA
  • NPI 1942200746
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1497795496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "866 DONNER AVE",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767136",
            "telephone_number": "360-708-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "866 DONNER AVE",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767136",
            "telephone_number": "360-708-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "ROBERT",
        "middle_name": "T",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "DO00001542",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "20A 4256",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "OP1542",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "3075PE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0209144",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8214223",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Personal Hearing Solutions
• Petaluma Icf DDH Inc
• Petaluma Valley Internal Medicine Inc
• Carole Marie Petersen, LCSW
• Charles Robert Pettit, M.D.
• Pharmaca Integrative Pharmacy, Inc.
• Hannah Elizabeth Philbin, LMFT, LPCC
• Peter Emmett Philbin, MD
• Melinda L Phoenix, L.AC
• Sita-Marie Kalyani Pillay, PSY.D., M.A.

• Emergency Medicine Physician in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.