MS. JUDITH KOMATSU N.P, L.A.C.
NPI 1346261005
Nurse Practitioner - Adult Health in Petaluma, CA
About Ms. Judith Komatsu N.p, L.a.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. JUDITH KOMATSU N.P, L.A.C. (NPI 1346261005) is an individual adult health provider in Petaluma, California, licensed in California (21030) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ms. Judith Komatsu N.p, L.a.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Judith Komatsu reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Petaluma, CA 94952
- Reassigned Medicare billing, California enrollment
- 3 clinicians in this Medicare group
Petaluma, CA 94954
- Reassigned Medicare billing, California enrollment
- 63 clinicians in this Medicare group
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.
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.
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 Judith Komatsu's NPI number?
The NPI number for Judith Komatsu is 1346261005. It was assigned to this individual provider in the NPPES registry on July 21, 2006.
Where is Judith Komatsu located?
Judith Komatsu practices at 1179 N Mcdowell Blvd, Petaluma, CA 94954. The listed phone number is (707) 559-7500.
What is Judith Komatsu's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Judith Komatsu enrolled in Medicare?
Yes. Judith Komatsu is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Judith Komatsu's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Judith Komatsu reassigns Medicare benefits to 2 organizations: Cp Sonoma N-Ca Hospice, LLC (Petaluma, CA) and Petaluma Health Center Inc (Petaluma, CA). Each 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 Judith Komatsu'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 Judith Komatsu was last updated on July 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Ms. Judith Komatsu, N.P, L.A.C. · NPI 1346261005
Adult Health physician in Petaluma, California. Individual provider, active in the CMS NPPES registry since July 21, 2006.
## Identity
- **NPI:** 1346261005 (Entity type: Individual)
- **Enumerated:** July 21, 2006
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** 21030 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1179 N MCDOWELL BLVD, Petaluma, CA 94954-6559
- **Phone:** (707) 559-7500 · **Fax:** (707) 559-7620
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Cp Sonoma N-Ca Hospice, LLC (NPI 1790507911, Petaluma, CA); Petaluma Health Center Inc (NPI 1588656268, Petaluma, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** July 6, 2012
- **Other identifiers:** Other LA792H (CA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1346261005) · Data from the CMS NPPES public registry.