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NICOLE SUSAN KETTERMAN M.D.
NPI 1194977249
Pediatrics in San Carlos, CA

Active since October 21, 2008PECOS Enrolled
301 INDUSTRIAL RD, SAN CARLOS, CA 94070(650) 596-4000 Get Directions Write a Review

NPPES record last updated: May 28, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 28, 2020, Dec 4, 2018 (2 updates tracked since 2018).

About Nicole Susan Ketterman M.d. NPPES

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

NICOLE SUSAN KETTERMAN M.D. (NPI 1194977249) is an individual pediatrics provider in San Carlos, California, licensed in California (A105499) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194977249
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameNICOLE SUSAN KETTERMANCredential: M.D.
Location Address301 INDUSTRIAL RDSan Carlos, CA 94070-2603
Mailing Address325 Distel CirLos Altos, CA 94022-1408 · (650) 596-4000
Phone(650) 596-4000
Sole ProprietorNo
Enumeration DateOctober 21, 2008
Last NPPES UpdateMay 28, 20202 updates tracked since enumeration
NPPES CertifiedMay 28, 2020
✔ NPI 1194977249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A105499
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.
301 INDUSTRIAL RD, San Carlos, CA 94070
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Other Names 1

Former Name (1)Dr. Nicole Susan Ipakchi M.d.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Susan Ketterman M.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94070 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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 20

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

REBECCA ASHE MD
Internal Medicine
301 INDUSTRIAL RD
SAN CARLOS, CA 94070
San Mateo County (650) 596-4000
SARAH CHEYETTE MD
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
301 INDUSTRIAL RD
SAN CARLOS, CA 94070
San Mateo County (650) 596-4000
DR. ANDREA M TOM M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
301 INDUSTRIAL RD
SAN CARLOS, CA 94070
San Mateo County (650) 596-4030
GINELLE SUAREZ MERRILL PTA
Physical Therapy Assistant
301 INDUSTRIAL RD
SAN CARLOS, CA 94070
San Mateo County (650) 321-4121
NAVEEN MAHMOOD MD
Pediatrics
301 INDUSTRIAL RD
SAN CARLOS, CA 94070
San Mateo County (650) 596-4000
DR. LAUREN KUTZSCHER THOMPSON MD, MS
Pediatrics
301 INDUSTRIAL RD
SAN CARLOS, CA 94070
San Mateo County (650) 596-4000
DR. HINA CHAWLA M.D.
Emergency Medicine
301 INDUSTRIAL RD
SAN CARLOS, CA 94070
San Mateo County (650) 596-4100
MRS. DIANA TATARKHANOVA NP
Nurse Practitioner (Obstetrics & Gynecology)
301 INDUSTRIAL RD
SAN CARLOS, CA 94070
San Mateo County (650) 596-4240

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 Nicole Ketterman's NPI number?

The NPI number for Nicole Ketterman is 1194977249. It was assigned to this individual provider in the NPPES registry on October 21, 2008. The provider is also known as Dr. Nicole Susan Ipakchi M.D..

Where is Nicole Ketterman located?

Nicole Ketterman practices at 301 Industrial Rd, San Carlos, CA 94070. The listed phone number is (650) 596-4000.

What is Nicole Ketterman's specialty?

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

Is Nicole Ketterman enrolled in Medicare?

Yes. Nicole Ketterman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicole Ketterman was last updated on May 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.