Individual provider Active NPI

Patricia Louise Kulbeth, RD

  • Registered Dietitian
  • Roseville, CA
National Provider Identifier
1821338112
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
655302
Practice address
3400 Douglas Blvd Ste 225
Roseville, CA 95661-4283
Phone
(916) 740-3721
Fax
(916) 783-0513
NPI assigned
Feb 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1762 KS
Registered Dietitian 133V00000X 655302 Primary

Addresses

Primary practice location

3400 Douglas Blvd Ste 225
Roseville, CA 95661-4283

Mailing address

3400 Douglas Blvd Ste 225
Roseville, CA 95661-4283
Phone (916) 740-3721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200504002368 CO Practitioner - Registered Dietitian Or Nutrition Professional 4688005853
I20220809003837 CA Practitioner - Registered Dietitian Or Nutrition Professional 4688005853 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1762KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Uch-MHS CurrentSince Apr 9, 2020 Accepting new patients
Siskiyou Hospital, Inc. CurrentSince Aug 7, 2023 Accepting new patients
Telehealth Specialty Medical Group CurrentSince May 1, 2022 Accepting new patients
Uch-MHS Past Accepting new patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients

Locations

9471 Haven Ave
Ste 140
Rch Cucamonga, CA 91730
Phone (909) 474-2333

3400 Douglas Blvd
Ste 170
Roseville, CA 95661
Phone (855) 446-8628

3400 Douglas Blvd
Ste 225
Roseville, CA 95661
Phone (916) 740-3721

3400 Douglas Blvd
Ste 224
Roseville, CA 95661

475 Bruce St
Yreka, CA 96097
Phone (530) 842-3507

444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256

175 S Union Blvd
Ste 250
Colorado Springs, CO 80910
Phone (719) 365-1624

175 S Union Blvd
Ste 300
Colorado Springs, CO 80910
Phone (719) 365-6363

5360 N Academy Blvd
Ste 220
Colorado Springs, CO 80918
Phone (719) 598-3585

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

Interoperability endpoints

  • Direct secure messaging: telemed2u.patricialouisekulbeth@160918.advancedmd-direct.com

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": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1821338112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DOUGLAS BLVD STE 225",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614283",
            "telephone_number": "916-740-3721",
            "fax_number": "916-783-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DOUGLAS BLVD STE 225",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614283",
            "telephone_number": "916-740-3721",
            "fax_number": "916-783-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULBETH",
        "first_name": "PATRICIA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-22",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KS",
            "license": "1762",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "655302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.