Individual provider Active NPI

Manfred L Ramos, D.O.

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1720217235
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A12169 Issued in CA
Practice address
131 Stony Cir Ste 1600
Santa Rosa, CA 95401-9520
Phone
(707) 541-7700
Fax
(707) 573-5415
NPI assigned
Jul 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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 20A12169 CA Primary

Addresses

Primary practice location

131 Stony Cir Ste 1600
Santa Rosa, CA 95401-9520

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 906-4623

Other practice location 1

4700 Hoen Ave
Santa Rosa, CA 95405-7824
Phone (707) 526-3360

Other practice location 2

1550 Broadway
Ste 2
San Diego, CA 92101-5713
Phone (619) 906-4623

Other practice location 3

1383 N McDowell Blvd Ste 150
Petaluma, CA 94954-7118
Phone (707) 573-5240

Other practice location 4

34 Mark West Springs Rd Fl 3
Santa Rosa, CA 95403-1766
Phone (707) 573-5240

Other practice location 5

5300 Snyder Ln Ste A
Rohnert Park, CA 94928-2915
Phone (707) 526-3360

Other practice location 6

34 Mark West Springs Rd Fl 2
Santa Rosa, CA 95403-1766
Phone (707) 573-5240

Other practice location 7

717 Center St
Healdsburg, CA 95448-3604
Phone (707) 541-7700

Other practice location 8

2455 Summerfield Rd
Santa Rosa, CA 95405-7815
Phone (707) 541-7700

Other practice location 9

4702 Hoen Ave
Santa Rosa, CA 95405-7824
Phone (707) 526-3360

Other practice location 10

3883 Airway Dr Ste 120
Santa Rosa, CA 95403-1678
Phone (707) 573-5240

Other identifiers 1

IdentifierTypeStateIssuer
20A12169OtherCASTATE MEDICAL LICENSE

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
I20151030002164 CA Practitioner - Family Practice 2163600263 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12169CAMDOptometrist
20A12169CAMDFamily Medicine Physician
1162ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgecrest Regional Hospital CurrentSince Jul 1, 2024 Accepting new patients
Ridgecrest Regional Hospital CurrentSince Jul 1, 2024 Accepting new patients
Regents of the University of California CurrentSince Jul 23, 2018 Accepting new patients
Regents of the University of California CurrentSince Jul 23, 2018 Accepting new patients
Ridgecrest Regional Hospital Current Accepting new patients

Locations

1111 N China Lake Blvd
#190
Ridgecrest, CA 93555
Phone (760) 499-3855

1041 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0121

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

1111 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-4571

2261 Douglas Blvd
Roseville, CA 95661
Phone (916) 783-1044

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1720217235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-906-4623",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 STONY CIR STE 1600",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954019520",
            "telephone_number": "707-541-7700",
            "fax_number": "707-573-5415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Hoen Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954057824",
            "country_code": "US",
            "telephone_number": "707-526-3360",
            "fax_number": "707-573-5406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 BROADWAY",
            "address_2": "STE 2",
            "address_purpose": "LOCATION",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015713",
            "country_code": "US",
            "telephone_number": "619-906-4623",
            "fax_number": "619-906-4564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1383 N McDowell Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949547118",
            "country_code": "US",
            "telephone_number": "707-573-5240",
            "fax_number": "707-573-5416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34 Mark West Springs Rd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031766",
            "country_code": "US",
            "telephone_number": "707-573-5240",
            "fax_number": "707-573-5416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5300 Snyder Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Rohnert Park",
            "state": "CA",
            "postal_code": "949282915",
            "country_code": "US",
            "telephone_number": "707-526-3360",
            "fax_number": "707-573-5406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34 Mark West Springs Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031766",
            "country_code": "US",
            "telephone_number": "707-573-5240",
            "fax_number": "707-573-5416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "717 Center St",
            "address_purpose": "LOCATION",
            "city": "Healdsburg",
            "state": "CA",
            "postal_code": "954483604",
            "country_code": "US",
            "telephone_number": "707-541-7700",
            "fax_number": "707-573-5415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2455 Summerfield Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954057815",
            "country_code": "US",
            "telephone_number": "707-541-7700",
            "fax_number": "707-573-5415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4702 Hoen Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954057824",
            "country_code": "US",
            "telephone_number": "707-526-3360",
            "fax_number": "707-573-5406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3883 Airway Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031678",
            "country_code": "US",
            "telephone_number": "707-573-5240",
            "fax_number": "707-573-5416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "MANFRED",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "20A12169",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.