Individual provider Active NPI

Jill Schmidtlein Zechowy, M.D., M.S.

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1639375074
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A76643 Issued in CA
Practice address
725 College Ave
Santa Rosa, CA 95404-4106
Phone
(707) 515-6673
NPI assigned
Jun 22, 2007
Last updated
Jun 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A76643 CA Primary

Addresses

Primary practice location

725 College Ave
Santa Rosa, CA 95404-4106

Mailing address

725 College Ave
Santa Rosa, CA 95404-4106
Phone (707) 515-6673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 10, 2024 through Apr 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
A76643CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Faculty Medical Group Inc Past Accepting new patients

Organizations & group practices 1

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1639375074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 COLLEGE AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044106",
            "telephone_number": "707-515-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 COLLEGE AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044106",
            "telephone_number": "707-515-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZECHOWY",
        "first_name": "JILL",
        "middle_name": "SCHMIDTLEIN",
        "name_prefix": "Dr.",
        "credential": "M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.