Active NPI
Elizabeth Suzanne Culhane, M.D.
- Pediatrics Physician
- Santa Rosa, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G74888
- Practice address
- 500 Doyle Park Dr
Suite 100
Santa Rosa, CA 95405-4558 - Phone
- (707) 544-6090
- Fax
- (707) 544-2389
- NPI assigned
- Aug 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G74888 | CA | Primary |
Addresses
Primary practice location
500 Doyle Park Dr
Suite 100
Santa Rosa, CA 95405-4558
Mailing address
500 Doyle Park Dr
Suite 100
Santa Rosa, CA 95405-4558
Phone (707) 544-6090
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | eculhane1657594@oc.providencedirect.org |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Rush Medical College of Rush University, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74888 | CA | MD | Pharmacist |
| G74888 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Providence Medical Foundation | Past | Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805
500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842
1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
Organizations & group practices 5
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1508979923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 DOYLE PARK DR",
"address_2": "SUITE 100",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954054558",
"telephone_number": "707-544-6090",
"fax_number": "707-544-2389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 DOYLE PARK DR",
"address_2": "SUITE 100",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954054558",
"telephone_number": "707-544-6090",
"fax_number": "707-544-2389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULHANE",
"first_name": "ELIZABETH",
"middle_name": "SUZANNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G74888",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "eculhane1657594@oc.providencedirect.org",
"affiliation": "N",
"address_1": "500 Doyle Park Dr",
"address_2": "Suite 100",
"city": "Santa Rosa",
"state": "CA",
"country_code": "US",
"postal_code": "954054558",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.