NPIMap

Individual provider Active NPI

Mark R Northfield, MD

  • Orthopaedic Surgery Physician
  • Petaluma, CA
National Provider Identifier
1861406316
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G77114 Issued in CA
Practice address
1496 Professional Drive
Suite 601
Petaluma, CA 94954
Phone
(707) 778-1131
Fax
(707) 778-3818
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G77114 CA Primary

Addresses

Primary practice location

1496 Professional Drive
Suite 601
Petaluma, CA 94954

Mailing address

1496 Professional Drive
Suite 601
Petaluma, CA 94954
Phone (707) 778-1131

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnorthfield1658119@oc.providencedirect.org

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
I20100913000041 CA Practitioner - Orthopedic Surgery 3779608997 Reassigns benefits to 1 organization
Practice locations: Petaluma, CA

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Warren Alpert Medical School of Brown University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1496 Professional Dr
Suite 601
Petaluma, CA 94954-6698
Phone (707) 778-1131

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement11
Knee replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G77114CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Apr 3, 2017 Accepting new patients
Providence Medical Foundation CurrentSince Apr 3, 2017 Accepting new patients
Providence Medical Foundation Past Accepting new patients
Sonoma Valley Health Care District Past Accepting new patients
SRM Alliance Hospital Services Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1496 Professional Dr
Ste 601
Petaluma, CA 94954
Phone (707) 778-1131

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

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 2

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1861406316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1496 PROFESSIONAL DRIVE",
            "address_2": "SUITE 601",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-778-1131",
            "fax_number": "707-778-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1496 PROFESSIONAL DRIVE",
            "address_2": "SUITE 601",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-778-1131",
            "fax_number": "707-778-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHFIELD",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G77114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnorthfield1658119@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1496 Professional Drive",
            "address_2": "Suite 601",
            "city": "Petaluma",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.