NPIMap

Individual provider Active NPI

Claudia M Petruncio, DO

  • Internal Medicine Physician
  • Willits, CA
National Provider Identifier
1699719369
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15732 Issued in CA
Practice address
3 Marcela Dr
Willits, CA 95490-5769
Phone
(707) 459-6115
Fax
(856) 429-3794
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS005158 PA
Internal Medicine Physician 207R00000X 25MB04695500 NJ
Internal Medicine Physician 207R00000X 15732 CA Primary

Addresses

Primary practice location

3 Marcela Dr
Willits, CA 95490-5769

Mailing address

3 Marcela Dr
Willits, CA 95490-5769

Other identifiers 2

IdentifierTypeStateIssuer
201290120MedicaidNJ
DO44603OtherCDS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190107002094 CA Practitioner - Internal Medicine 0446316889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willits Hospital IncGroup PAC ID 7416940697, 67 clinicians

Practice addresses (Care Compare)

1 Marcela Dr
Willits, CA 95490-5769
Phone (707) 459-6801

3 Marcela Dr
Willits, CA 95490-5769
Phone (707) 459-4220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
73.31
Promoting interoperability
92
Improvement activities
40
Cost
62

Merit-based Incentive Payment System (MIPS)

Final score
89.41 of 100Reported as group
Quality
86.32
Promoting interoperability
95
Improvement activities
40
Cost
66.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS005158PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ukiah Adventist Hospital CurrentSince Jan 20, 2022 Accepting new patients
Willits Hospital Inc. CurrentSince Nov 1, 2021 Accepting new patients
Ukiah Adventist Hospital CurrentSince Nov 1, 2021 Accepting new patients
Camden County Health Services Center Past Accepting new patients
Virtua Our Lady of Lourdes Hospital Inc Past Accepting new patients
Kennedy University Hospital, Inc. Past Accepting new patients

Locations

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

1 Marcela Dr
Willits, CA 95490
Phone (707) 456-3001

Organizations & group practices 6

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 4

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1699719369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARCELA DR",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954905769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MARCELA DR",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954905769",
            "telephone_number": "707-459-6115",
            "fax_number": "856-429-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUNCIO",
        "first_name": "CLAUDIA",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS005158",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB04695500",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "15732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201290120",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "DO44603",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willits, CA

Sources for this page

Verify at the official NPI Registry.