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IKIGAI PHYSICIAN GROUP INC
NPI 1043830813
Family Medicine in Fortuna, CA

Active since April 22, 2020CLIA 05D2266217 · Waiver
3429 RENNER DR STE B, FORTUNA, CA 95540(707) 726-2255(707) 949-9715 Get Directions Write a Review

NPPES record last updated: May 6, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 6, 2025, Nov 10, 2021, May 14, 2020 and 1 more (4 updates tracked since 2020).

About Ikigai Physician Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IKIGAI PHYSICIAN GROUP INC (NPI 1043830813) is a healthcare organization registered as a family medicine in Fortuna, California and active in the NPI registry since April 2020. The organization holds a CLIA Waiver certificate valid through April 26, 2028, maintains a secondary practice location in Arcata, and lists Katherine Anne Talbert Estlin, Owner, as its authorized official.

NPPES Registry Identity

NPI1043830813
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameIKIGAI PHYSICIAN GROUP INC
Location Address3429 RENNER DR STE BFortuna, CA 95540-3104
Mailing Address3429 Renner Dr Ste BFortuna, CA 95540-3104 · (707) 726-2255 · Fax (707) 949-9715
Phone(707) 726-2255
Fax(707) 949-9715
Organization SubpartNo
Authorized OfficialKatherine Anne Talbert EstlinOwner · (707) 726-2255
Enumeration DateApril 22, 2020
Last NPPES UpdateMay 6, 20254 updates tracked since enumeration
NPPES CertifiedMay 6, 2025
✔ NPI 1043830813 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3429 RENNER DR STE B, Fortuna, CA 95540
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Secondary Practice Location 1

Location 13798 Janes Rd Ste 15Arcata, CA 95521-4746 · Phone (707) 726-2255

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ikigai Physician Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Ikigai Physician Group Inc, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Stephanie Dittmer, MD
Family Practice
NPI 1942422688
3429 RENNER DR
Fortuna, CA 95540
(707) 726-2255
✔ PECOS✔ Accepts MedicareSame address
Tamara Douglass, M.D.
Family Practice
NPI 1952396103
3429 RENNER DR STE B
Fortuna, CA 95540
(707) 726-2255
✔ PECOS✔ Accepts MedicareSame address
Katherine Estlin, MD
Family Practice
NPI 1255574885
3429 RENNER DR
Fortuna, CA 95540
(707) 726-2255
✔ PECOS✔ Accepts MedicareSame address
Steven Aussenberg, M.D.
Family Practice
NPI 1174902936
3798 JANES RD STE 15
Arcata, CA 95521
(707) 726-2255
✔ PECOS✔ Accepts Medicare22 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2266217

Ikigai Physician Group · Fortuna, CA
Active · expires Apr 26, 2028
CLIA Number05D2266217
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2026
Certificate Expiration DateApril 26, 2028
Laboratory DirectorKatherine Estlin
Laboratory Phone(707) 726-2255
Laboratory LocationIkigai Physician Group3429 Renner Dr Ste B, Fortuna, CA 95540
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ikigai Physician Group Inc's NPI number?

The NPI number for Ikigai Physician Group Inc is 1043830813. It was assigned to this organization in the NPPES registry on April 22, 2020.

Where is Ikigai Physician Group Inc located?

Ikigai Physician Group Inc is located at 3429 Renner Dr Ste B, Fortuna, CA 95540. The listed phone number is (707) 726-2255.

What is Ikigai Physician Group Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ikigai Physician Group Inc enrolled in Medicare?

Yes. Ikigai Physician Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ikigai Physician Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Family Practice, reassign their Medicare billing to Ikigai Physician Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Ikigai Physician Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2266217) is associated with this NPI, valid through April 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ikigai Physician Group Inc was last updated on May 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.