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WILLIAM F KIVETT MD INC
NPI 1164024394
Dermatology in Santa Rosa, CA

Active since November 12, 2020CLIA 05D2259881 · Certificate of Compliance
1140 SONOMA AVE STE 1A, SANTA ROSA, CA 95405(707) 275-6410(707) 275-6075 Get Directions Write a Review

NPPES record last updated: February 5, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 5, 2021, Nov 12, 2020 (2 updates tracked since 2020).

About William F Kivett Md Inc NPPES

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

WILLIAM F KIVETT MD INC (NPI 1164024394) is a healthcare organization registered as a dermatology in Santa Rosa, California and active in the NPI registry since November 2020. The organization holds a CLIA Certificate of Compliance certificate valid through June 4, 2027 and lists William F Kivett, Owner, as its authorized official.

NPPES Registry Identity

NPI1164024394
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameWILLIAM F KIVETT MD INC
Location Address1140 SONOMA AVE STE 1ASanta Rosa, CA 95405-4817
Mailing AddressPo Box 2196Windsor, CA 95492-2196 · (707) 291-5096
Phone(707) 275-6410
Fax(707) 275-6075
Organization SubpartNo
Authorized OfficialWilliam F KivettOwner · (707) 291-5096
Enumeration DateNovember 12, 2020
Last NPPES UpdateFebruary 5, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2021
✔ NPI 1164024394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedPlastic Surgery · Surgery of the HandTaxonomy 2082S0105X
Also ListedSurgery · Plastic and Reconstructive SurgeryTaxonomy 2086S0122X
1140 SONOMA AVE STE 1A, Santa Rosa, CA 95405
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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 MULTIPLE 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)

William F Kivett Md Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to William F Kivett MD Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

William Kivett, MD, FAAD, FACS
Dermatology
NPI 1235175902
1140 SONOMA AVE STE 1A
Santa Rosa, CA 95405
(707) 275-6410
✔ PECOS✔ Accepts MedicareSame address

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 Compliance 05D2259881

William F Kivett MD Inc. · Santa Rosa, CA
Active · expires Jun 4, 2027
CLIA Number05D2259881
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2025
Certificate Expiration DateJune 4, 2027
Laboratory DirectorDr. William F. Kivett
Laboratory Phone(707) 291-5096
Laboratory LocationWilliam F Kivett MD Inc.1140 Sonoma Ave, Ste 1A, Santa Rosa, CA 95405
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 William F Kivett MD Inc's NPI number?

The NPI number for William F Kivett MD Inc is 1164024394. It was assigned to this organization in the NPPES registry on November 12, 2020.

Where is William F Kivett MD Inc located?

William F Kivett MD Inc is located at 1140 Sonoma Ave Ste 1A, Santa Rosa, CA 95405. The listed phone number is (707) 275-6410.

What is William F Kivett MD Inc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is William F Kivett MD Inc enrolled in Medicare?

Yes. William F Kivett MD Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through William F Kivett MD Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to William F Kivett MD 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does William F Kivett MD Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D2259881) is associated with this NPI, valid through June 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for William F Kivett MD Inc was last updated on February 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.