Active NPI
Kathleen Marie Persky, MD
- Surgery Physician
- Ukiah, CA
National Provider Identifier
1952309288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 00G566600
- Practice address
- 246 Hospital Dr
Ukiah, CA 95482-4533 - Phone
- (707) 463-8011
- Fax
- (707) 463-8044
- NPI assigned
- Jul 11, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 00G566600 | CA | Primary |
| General Practice Physician | 208D00000X | 00G566600 | CA |
Addresses
Primary practice location
246 Hospital Dr
Ukiah, CA 95482-4533
Mailing address
PO Box 2739
Ukiah, CA 95482-2739
Phone (707) 463-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G566600 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100827000087 | CA | Practitioner - General Surgery | 3779607759 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of California, San Diego School of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ukiah Adventist Hospital
Practice addresses (Care Compare)
246 Hospital Dr
Ukiah, CA 95482-4533
Phone (707) 463-8011
Hospital & facility affiliations
- Adventist Health Ukiah Valley
- Adventist Health Mendocino Coast
- Adventist Health Howard Memorial
- Adventist Health Clearlake
- Sutter Lakeside Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.77 of 100
- Quality
- 81.54
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.98 of 100
- Quality
- 73.31
- Promoting interoperability
- 92
- Improvement activities
- 40
- Cost
- 62
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.16 of 100
- Quality
- 82.56
- Promoting interoperability
- 93
- Improvement activities
- 40
- Cost
- 69.49
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 45 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00G566600 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ukiah Adventist Hospital | Current | Accepting new patients | |
| Ukiah Adventist Hospital | Current | Accepting new patients | |
| Adventist Health Physicians Network | Current | Accepting new patients | |
| Adventist Health Physicians Network | Surgery | Current | Accepting new patients |
| Adventist Health Physicians Network | Current | Accepting new patients | |
| Adventist Health California Medical Group, Inc. | Past | Accepting new patients |
Locations
15322 Lakeshore Dr
Ste 102
Clearlake, CA 95422
Phone (707) 994-2030
260 Hospital Dr
Ste 207
Ukiah, CA 95482
Phone (707) 463-7627
246 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-1928
1050 N State St
Ukiah, CA 95482
Phone (707) 463-7488
275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900
260 Hospital Dr
Ste 204
Ukiah, CA 95482
Phone (707) 463-8032
Organizations & group practices 9
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.
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- Willits, CA
- NPI 1629432968
-
- Rural Health Clinic/Center
- Fort Bragg, CA
- NPI 1588095848
-
- Rural Health Clinic/Center
- Ukiah, CA
- NPI 1770653362
-
- Rural Health Clinic/Center
- Ukiah, CA
- NPI 1952471542
-
- Physical Therapy Clinic/Center
- Paradise, CA
- NPI 1134092190
-
- Internal Medicine Physician
- Saint Helena, CA
- NPI 1437474269
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Clearlake, CA
- NPI 1124018031
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1952309288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2739",
"city": "UKIAH",
"state": "CA",
"postal_code": "954822739",
"telephone_number": "707-463-8000",
"fax_number": "707-462-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "246 HOSPITAL DR",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824533",
"telephone_number": "707-463-8011",
"fax_number": "707-463-8044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERSKY",
"first_name": "KATHLEEN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-11",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "00G566600",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "00G566600",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G566600",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.