NPIMap

Organization Active NPI

Redwood Fam Dermatology Medical Associates - a Medical Corporation

Doing business as Redwood Family Dermatology

  • Dermatology Physician
  • Santa Rosa, CA
National Provider Identifier
1710913231
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
REDWOOD FAM DERMATOLOGY MEDICAL ASSOCIATES - A MEDICAL CORPORATION
Doing business as
Redwood Family Dermatology
Practice address
2725 Mendocino Ave
Santa Rosa, CA 95403-2805
Phone
(707) 545-4537
Fax
(707) 545-6726
NPI assigned
Jun 25, 2006
Last updated
Apr 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Dr. Jeffrey Sugarman, M.D., PH.D.NPI 1548255482
Title
Owner/President
Phone
(707) 545-4537

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

2725 Mendocino Ave
Santa Rosa, CA 95403-2805

Mailing address

2725 Mendocino Ave
Santa Rosa, CA 95403-2805
Phone (707) 545-4537

Other practice location 1

555 S Dora St
Ukiah, CA 95482-5424
Phone (707) 462-3996

Other practice location 2

4727 Hoen Ave Ste A
Santa Rosa, CA 95405-7898
Phone (707) 545-4537

Other names 1

  • Redwood Family Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407001642 CA Part B Supplier - Clinic/Group Practice 0446243034 Receives reassigned benefits from 19 practitioners
Practice locations: Lakeport, CA; Santa Rosa, CA; Ukiah, CA; Healdsburg, CA

National Provider Directory

National Provider Directory

Locations

409 East St
Healdsburg, CA 95448
Phone (707) 433-4829

750 Las Gallinas Ave
Ste 205
San Rafael, CA 94903
Phone (415) 472-3903

2725 Mendocino Ave
Santa Rosa, CA 95403
Phone (707) 542-6313

2755 Mendocino Ave
Santa Rosa, CA 95403
Phone (707) 873-4806

990 Sonoma Ave
Ste 9
Santa Rosa, CA 95404
Phone (707) 545-4537

1165 S Dora St
Ste F2
Ukiah, CA 95482
Phone (707) 462-3996

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1710913231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 MENDOCINO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032805",
            "telephone_number": "707-545-4537",
            "fax_number": "707-545-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 MENDOCINO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032805",
            "telephone_number": "707-545-4537",
            "fax_number": "707-545-6726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 S Dora St",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954825424",
            "country_code": "US",
            "telephone_number": "707-462-3996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4727 Hoen Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954057898",
            "country_code": "US",
            "telephone_number": "707-545-4537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REDWOOD FAM DERMATOLOGY MEDICAL ASSOCIATES - A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "SUGARMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "707-545-4537",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redwood Family Dermatology",
            "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 Apr 17, 2024; 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.