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MRS. FAYE SUSAN LUNDERGAN MD
NPI 1174554240
Pediatrics in Petaluma, CA

Active since July 06, 2006PECOS Enrolled
1456 PROFESSIONAL DR STE 405, PETALUMA, CA 94954(707) 769-7500(707) 769-7570 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Faye Susan Lundergan Md NPPES

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

MRS. FAYE SUSAN LUNDERGAN MD (NPI 1174554240) is an individual pediatrics provider in Petaluma, California, licensed in California (A76943) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174554240
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMRS. FAYE SUSAN LUNDERGANCredential: MD
Location Address1456 PROFESSIONAL DR STE 405Petaluma, CA 94954
Mailing Address1456 Professional Dr, Ste 405Petaluma, CA 94954 · (707) 769-7500 · Fax (707) 769-7570
Phone(707) 769-7500
Fax(707) 769-7570
Sole ProprietorYes
Enumeration DateJuly 6, 2006
Last NPPES UpdateMarch 31, 2025
NPPES CertifiedMarch 31, 2025
✔ NPI 1174554240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A76943
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1456 PROFESSIONAL DR STE 405, Petaluma, CA 94954
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Faye Susan Lundergan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Faye Lundergan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Regents Univ Of California Ucsf
35 mi
Internal Medicine
505 PARNASSUS AVE
San Francisco, CA 94143
  • Reassigned Medicare billing, California enrollment
  • 339 clinicians in this Medicare group
NPI 1124439807 (415) 476-1000

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

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 2

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

PAUL F. CAMPION, M.D.
Durable Medical Equipment & Medical Supplies
1456 PROFESSIONAL DR STE 405
PETALUMA, CA 94954
Sonoma County (707) 763-6400
BROOKE COOPER RAVA FNP
Nurse Practitioner (Family)
1456 PROFESSIONAL DR STE 405
PETALUMA, CA 94954
Sonoma County (707) 769-7500

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 Faye Lundergan's NPI number?

The NPI number for Faye Lundergan is 1174554240. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is Faye Lundergan located?

Faye Lundergan practices at 1456 Professional Dr Ste 405, Petaluma, CA 94954. The listed phone number is (707) 769-7500.

What is Faye Lundergan's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Faye Lundergan enrolled in Medicare?

Yes. Faye Lundergan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Faye Lundergan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Faye Lundergan reassigns Medicare benefits to Regents Univ Of California Ucsf (San Francisco, CA). The 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 Faye Lundergan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Faye Lundergan was last updated on March 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.