KELLEY LIAO MD
NPI 1053053694
Family Medicine in Petaluma, CA

Q: What is Kelley Liao's NPI number?

The NPI number for Kelley Liao is 1053053694. It was assigned to this individual provider in the NPPES registry on April 13, 2022.

Q: What is Kelley Liao's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelley Liao was last updated on August 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since April 13, 2022PECOS Enrolled

335 S MCDOWELL BLVD, PETALUMA, CA 94954(628) 336-5260(628) 240-2138 Get Directions Write a Review

NPPES record last updated: August 8, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 8, 2025, Apr 13, 2022 (2 updates tracked since 2022).

On this page

About Kelley Liao Md NPPES

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

KELLEY LIAO MD (NPI 1053053694) is an individual family medicine provider in Petaluma, California, licensed in California (A200873) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Texas A & M University System, Hsc, College Of Medicine (2022).

NPPES Registry Identity

NPI1053053694

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameKELLEY LIAOCredential: MD

Location Address335 S MCDOWELL BLVDPetaluma, CA 94954-3507

Mailing Address335 S Mcdowell BlvdPetaluma, CA 94954-3507 · (628) 336-5260 · Fax (628) 240-2138

Phone(628) 336-5260

Fax(628) 240-2138

Sole ProprietorNo

Medical School CMSTexas A & M University System, Hsc, College Of MedicineGraduated 2022

Enumeration DateApril 13, 2022

Last NPPES UpdateAugust 8, 20252 updates tracked since enumeration

NPPES CertifiedAugust 8, 2025

✔ NPI 1053053694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · A200873

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.

335 S MCDOWELL BLVD, Petaluma, CA 94954

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelley Liao Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698157675

PECOS Enrollment IDI20250715003468

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94954 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEAH HEINRICH NP

Nurse Practitioner (Adult Health)