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NPI 1306180146ActiveIndividual· Internal Medicine, Infectious Disease· Santa Rosa, CA
Internal Medicine, Infectious Disease with Providence Medical Foundation, practicing in Santa Rosa, California. 172 Medicare patients in 2024, $101,720 paid; nearly all of their 116 Part D prescriptions were generic (97%). Lists Petaluma Valley Hospital and 2 other hospitals as hospital affiliations.
Overview
| NPI | 1306180146 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Nov 17, 2012 |
| Last updated in NPPES | Nov 11, 2021 |
| Certified by provider | Nov 11, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Infectious Disease Primary | 207RI0200X | A134154 | CA |
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 Practitioner - Infectious Disease (CA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 172 |
|---|---|
| Services billed | 1,050 across 11 procedure codes |
| Paid by Medicare | $101,720 |
Part D prescriptions in 2024
| Prescriptions (claims) | 116 · 128 30-day fills |
|---|---|
| Patients | 24 |
| Total drug cost | $16,922 |
| Generic share | 97% of claims |
Education and affiliations
| Graduation year | 2010 |
|---|---|
| Medicare specialty | Infectious Disease |
| Secondary specialties | Internal Medicine |
| Telehealth | Offers telehealth |
Medical group
- Providence Medical FoundationVictorville, CA · 1,466 clinicians
Hospital affiliations
- Petaluma Valley HospitalPetaluma, CA
- Providence Santa Rosa Memorial HospitalSanta Rosa, CA
- UCSF Medical CenterSan Francisco, CA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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