Individual provider Active NPI

Eunjie Klegar, M.D.

  • Psychiatry Physician
  • Santa Rosa, CA
National Provider Identifier
1548568413
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
051130 Issued in CT
Practice address
2235 Challenger Way
Santa Rosa, CA 95407-5458
Phone
(707) 565-4900
NPI assigned
Mar 2, 2011
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 051130 CT Primary

Addresses

Primary practice location

2235 Challenger Way
Santa Rosa, CA 95407-5458

Mailing address

2235 Challenger Way
Santa Rosa, CA 95407-5458
Phone (707) 565-4900

Other practice location 1

3019 County Complex Dr
Canandaigua, NY 14424-9505
Phone (585) 369-4363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20140611000667 CT Practitioner - Psychiatry 5799909883 Reassigns benefits to 2 organizations
I20220708001137 NY Practitioner - Psychiatry 5799909883 Reassigns benefits to 1 organization
I20240416003468 CA Practitioner - Psychiatry 5799909883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ontario CountyGroup PAC ID 3779482252, 10 clinicians
County of KernGroup PAC ID 7810887205, 75 clinicians

Practice addresses (Care Compare)

3019 County Complex Dr
Canandaigua, NY 14424-9505
Phone (585) 396-4552

3715 Columbus St
Bakersfield, CA 93306-2719
Phone (661) 868-6600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
051130CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health, Inc. Psychiatry CurrentSince Oct 1, 2013 Accepting new patients
State of Connecticut CurrentSince Dec 4, 2020 Accepting new patients
County of Kern Psychiatry CurrentSince Feb 13, 2024 Accepting new patients
County of Kern CurrentSince Feb 13, 2024 Accepting new patients
County of Kern Psychiatry Current Accepting new patients
State of Connecticut CurrentSince Dec 4, 2020 Accepting new patients

Locations

2525 N Chester Ave
Bakersfield, CA 93308
Phone (661) 328-4295

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

Interoperability endpoints

  • Direct secure messaging: eunjie.klegar@xdr.hhchealthdirect.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1548568413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075458",
            "telephone_number": "707-565-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075458",
            "telephone_number": "707-565-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3019 County Complex Dr",
            "address_purpose": "LOCATION",
            "city": "Canandaigua",
            "state": "NY",
            "postal_code": "144249505",
            "country_code": "US",
            "telephone_number": "585-369-4363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEGAR",
        "first_name": "EUNJIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "051130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.