NPIMap

Organization Active NPI

Sutter Medical Foundation

Doing business as Sutter Medical Foundation North Bay

  • Internal Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1710162292
Registry record updated Oct 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SUTTER MEDICAL FOUNDATION
Doing business as
Sutter Medical Foundation North Bay
Practice address
625 Steele LN
Santa Rosa, CA 95403-3127
Phone
(707) 576-4828
NPI assigned
Jan 3, 2008
Last updated
Oct 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SUTTER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2026

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

Authorized official

Name
Leia M Sanders
Title
Sr Director, Cred, Enroll, Alignmen
Phone
(650) 934-7000

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X
Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 247100000X
Mammography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471M2300X
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

625 Steele LN
Santa Rosa, CA 95403-3127

Mailing address

3883 Airway Dr
Suite 300
Santa Rosa, CA 95403-1670
Phone (707) 576-4828

Other names 1

  • Sutter Medical Foundation North Bay Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090311000335 CA Part B Supplier - Clinic/Group Practice 9830094515 Receives reassigned benefits from 3,204 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Sutter Health

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793145600000",
    "number": "1710162292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR",
            "address_2": "SUITE 300",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031670",
            "telephone_number": "707-576-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 STEELE LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033127",
            "telephone_number": "707-576-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUTTER HEALTH",
        "enumeration_date": "2008-01-03",
        "last_updated": "2026-10-28",
        "certification_date": "2026-10-28",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "LEIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR DIRECTOR, CRED, ENROLL, ALIGNMEN",
        "authorized_official_telephone_number": "650-934-7000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471M2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Mammography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Medical Foundation North Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.