Petrina Kaluzhny

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

A145644 Issued in CA

Practice address

2516 Stockton Blvd
Sacramento, CA 95817-2208

Phone

(916) 703-0279

NPI assigned

Mar 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Pediatrics

  Medicare reassignment NPD
• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Pediatrics

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406
  NPD
• Regents of the University of Ca

  • Pediatrics Physician
  • Sacramento, CA
  • NPI 1386637346
  NPD

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1922425974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 19TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941213804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-703-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALUZHNY",
        "first_name": "PETRINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A145644",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "A145644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Koree Theresa Kalmbach
• Brianna Christine Kalmykow
• Kalpesh Patel DDS PC
• Katherine Louise Kalthoff, DPM
• Lisa Carrie Kalua
• Yelena Kalyuta, RBT
• Layal Kamal
• Sally Medhat Kamal, M.D.
• Amanda A Kamali, MD
• Shahnaz Kamali, LCSW

• Developmental - Behavioral Pediatrics Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Developmental - Behavioral Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.