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NPI 1194515106ActiveOrganization· Emergency Medicine· Petaluma, CA

Emergency Medicine in Petaluma, California, registered in NPPES in May 2025. The authorized official on file is Kim Larsen, Vp, Credentialing. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.

Overview

NPI	1194515106
Status	Active
Entity type	Organization
NPI issued	May 12, 2025
Last updated in NPPES	May 12, 2025
Certified by provider	May 12, 2025

Specialties and licenses

Taxonomy	Code	License	State
Emergency Medicine Primary	207P00000X	—	—
Family Medicine	207Q00000X	—	—
Internal Medicine	207R00000X	—	—

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Nov 10, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026	No match	—
New York OMIG · Nov 11, 2026	No match	—
Ohio Medicaid · Nov 11, 2026	No match	—
Pennsylvania Medicheck · Nov 11, 2026	No match	—
Washington HCA · Nov 11, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (CA); Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (HI); Part B Supplier - Clinic/Group Practice (ID); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (NH); Part B Supplier - Clinic/Group Practice (NJ); Part B Supplier - Clinic/Group Practice (NY); Part B Supplier - Clinic/Group Practice (SC); Part B Supplier - Clinic/Group Practice (TX); Part B Supplier - Clinic/Group Practice (UT); Part B Supplier - Clinic/Group Practice (VA)

Enrollment (PECOS)

Enrolled Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (CA); Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (HI); Part B Supplier - Clinic/Group Practice (ID); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (NH); Part B Supplier - Clinic/Group Practice (NJ); Part B Supplier - Clinic/Group Practice (NY); Part B Supplier - Clinic/Group Practice (SC); Part B Supplier - Clinic/Group Practice (TX); Part B Supplier - Clinic/Group Practice (UT); Part B Supplier - Clinic/Group Practice (VA)

Medicare sources and data years

Other emergency medicine physicians in Petaluma

Erick Ruiz Miranda, M.D.
Petaluma, CA · Individual
1669597167
Dan Schlager, MD
Petaluma, CA · Individual
1083798078
Veronique L. Au, MD
Petaluma, CA · Individual
1255399531
Kristin C. Kuzma
Petaluma, CA · Individual
1861717829
Jodi Lynn Adams, M.D.
Petaluma, CA · Individual
1962511766
Amy Adams, M.D.
Petaluma, CA · Individual
1700976610
Petaluma Emergency Physicians Medical Corporation
Petaluma, CA · Organization
1649201898

All emergency medicine physicians in California