RENEE DETTLOFF CNM
NPI 1285170951
Advanced Practice Midwife in Santa Rosa, CA

Q: What is Renee Dettloff's NPI number?

The NPI number for Renee Dettloff is 1285170951. It was assigned to this individual provider in the NPPES registry on January 18, 2017.

Q: What is Renee Dettloff's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Q: When was this NPI record last updated?

The NPPES record for Renee Dettloff was last updated on January 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 January 18, 2017PECOS Enrolled

583 SUMMERFIELD RD, SANTA ROSA, CA 95405(707) 539-1544 Get Directions Write a Review

NPPES record last updated: January 24, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 24, 2019, Jan 18, 2017 (2 updates tracked since 2017).

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About Renee Dettloff Cnm NPPES

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

RENEE DETTLOFF CNM (NPI 1285170951) is an individual advanced practice midwife in Santa Rosa, California, licensed in California (236013) and active in the NPI registry since January 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Greenville, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1285170951

Entity TypeIndividualFemale

Primary Taxonomy367A00000X

Provider Legal NameRENEE DETTLOFFCredential: CNM

Location Address583 SUMMERFIELD RDSanta Rosa, CA 95405-5239

Mailing Address1409 Yarberry LnPetaluma, CA 94954-1601

Phone(707) 539-1544

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJanuary 18, 2017

Last NPPES UpdateJanuary 24, 20192 updates tracked since enumeration

✔ NPI 1285170951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367A00000X

License✔ Licensed in CA · 236013

Definition

Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.

583 SUMMERFIELD RD, Santa Rosa, CA 95405

Open in Google Maps ↗

Secondary Practice Location 1

Location 1118 E Benton StGreenville, MI 48838-2333 · Phone (616) 258-2386

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Renee Dettloff Cnm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9931535226

PECOS Enrollment IDI20200205000271

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 Reassignments

Medicare enrollment records show Renee Dettloff reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Permanente Medical Group Inc

32 mi

Internal Medicine

975 SERENO DRIVE
Vallejo, CA 94589

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1336222397 (707) 651-1000

Regents Univ Of California Ucsf

49 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 95405 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

$77.94 typical visit price

range $21.02 – $153.40

Typical copayment $19.48 (range $5.25 – $38.35)

Most-billed visit code 99213

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 12

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

LUCINDA BECKLEY LMFT

Marriage & Family Therapist