Individual provider Active NPI

Julie Kiser, MD

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1669606505
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A54893 Issued in CA
Practice address
751 Lombardi CT # B
Santa Rosa, CA 95407-6793
Phone
(707) 547-2222
Fax
(707) 547-2229
NPI assigned
May 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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 A54893 CA Primary

Addresses

Primary practice location

751 Lombardi CT # B
Santa Rosa, CA 95407-6793

Mailing address

751 Lombardi CT # B
Santa Rosa, CA 95407-6793
Phone (707) 547-2222

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250605001984 CA Practitioner - Family Practice 6204066319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Washington University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 N Dutton Ave
Santa Rosa, CA 95401-7112
Phone (707) 303-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A54893CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers Current Accepting new patients
Santa Rosa Community Health Centers CurrentSince Feb 22, 2025 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Feb 22, 2025 Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Locations

3569 Round Barn Cir
Santa Rosa, CA 95403

751 Lombardi Ct
Ste B
Santa Rosa, CA 95407
Phone (707) 547-2220

1300 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 303-3395

Interoperability endpoints

  • Direct secure messaging: jkiser664001@direct.ochin.org
  • Direct secure messaging: jkiser627997@direct.ochin.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1669606505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 LOMBARDI CT # B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076793",
            "telephone_number": "707-547-2222",
            "fax_number": "707-547-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 LOMBARDI CT # B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076793",
            "telephone_number": "707-547-2222",
            "fax_number": "707-547-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISER",
        "first_name": "JULIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A54893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.