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

Q: 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..

Q: What is Nicole Ketterman's specialty?

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

Q: 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.

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: October 25, 2026.

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

On this page

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

Open in Google Maps ↗

Other Names 1

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

Medicare Participation & PECOS CMS

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

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.

Medicare Billing Reassignment

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

Sutter Bay Medical Foundation

7.4 mi

Multi-Specialty

795 EL CAMINO REAL
Palo Alto, CA 94301

Reassigned Medicare billing, California enrollment
4,479 clinicians in this Medicare group

NPI 1013950807 (650) 321-4121

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 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