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DR. PETER PONDOLFINO PSYD
NPI 1407918832
Psychologist - Clinical in Santa Rosa, CA

Active since December 14, 2006PECOS EnrolledAccepts Medicare Assignment
143 ALDERBROOK DR, SANTA ROSA, CA 95405(707) 322-4319 Get Directions Write a Review

NPPES record last updated: November 15, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Peter Pondolfino Psyd NPPES

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

DR. PETER PONDOLFINO PSYD (NPI 1407918832) is an individual clinical provider in Santa Rosa, California, licensed in California (24167) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1989).

NPPES Registry Identity

NPI1407918832
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. PETER PONDOLFINOCredential: PSYD
Location Address143 ALDERBROOK DRSanta Rosa, CA 95405-4650
Mailing AddressPo Box 2722Santa Rosa, CA 95405 · (707) 322-4319
Phone(707) 322-4319
Sole ProprietorYes
Medical School CMSOtherGraduated 1989
Enumeration DateDecember 14, 2006
Last NPPES UpdateNovember 15, 2013
✔ NPI 1407918832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · 24167
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
143 ALDERBROOK DR, Santa Rosa, CA 95405
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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 and accepts Medicare assignment

Dr. Peter Pondolfino Psyd 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.

PECOS PAC ID9739278193
PECOS Enrollment IDI20140114001117
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 Peter Pondolfino reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Psych Strategies Inc A Psychological Corp
Psychologist
1160 N DUTTON AVE, SUITE 230
Santa Rosa, CA 95401
  • Reassigned Medicare billing, California enrollment
  • 33 clinicians in this Medicare group
NPI 1699775411 (707) 303-3201

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
$187.01 typical visit price
range $63.04 – $187.01
Typical copayment $46.75 (range $15.76 – $46.75)
Most-billed visit code 99205
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.

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 Peter Pondolfino's NPI number?

The NPI number for Peter Pondolfino is 1407918832. It was assigned to this individual provider in the NPPES registry on December 14, 2006.

Where is Peter Pondolfino located?

Peter Pondolfino practices at 143 Alderbrook Dr, Santa Rosa, CA 95405. The listed phone number is (707) 322-4319.

What is Peter Pondolfino's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Peter Pondolfino enrolled in Medicare?

Yes. Peter Pondolfino 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 organization bills Medicare for Peter Pondolfino's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Peter Pondolfino reassigns Medicare benefits to Psych Strategies Inc A Psychological Corp (Santa Rosa, 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 Peter Pondolfino'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 Peter Pondolfino was last updated on November 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.