DR. KATHERINE PETTIBONE DPM
NPI 1740773035
Podiatrist in Santa Rosa, CA

Active since June 11, 2018PECOS EnrolledAccepts Medicare Assignment
2240 MERCURY WAY, SANTA ROSA, CA 95407(707) 570-3120 Get Directions Write a Review

NPPES record last updated: April 6, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 6, 2022, Feb 11, 2022, Jun 11, 2018 (3 updates tracked since 2018).

About Dr. Katherine Pettibone Dpm NPPES

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

DR. KATHERINE PETTIBONE DPM (NPI 1740773035) is an individual podiatrist in Santa Rosa, California, licensed in California (E5743) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS and is a graduate of California School Of Podiatric Medicine (2014).

NPPES Registry Identity

NPI1740773035
Entity TypeIndividualFemale
Primary Taxonomy213E00000X
Provider Legal NameDR. KATHERINE PETTIBONECredential: DPM
Location Address2240 MERCURY WAYSanta Rosa, CA 95407-5413
Mailing Address13380 Crest Valley DrReno, NV 89511-5916
Sole ProprietorNo
Medical School CMSCalifornia School Of Podiatric MedicineGraduated 2014
Enumeration DateJune 11, 2018
Last NPPES UpdateApril 6, 20223 updates tracked since enumeration
NPPES CertifiedApril 6, 2022
NPI 1740773035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License Licensed in CA · E5743
Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

2240 MERCURY WAY, Santa Rosa, CA 95407

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Katherine Pettibone Dpm 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 ID5799169884
PECOS Enrollment IDI20220909000214
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 95407 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 5

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

Family Medicine
2240 MERCURY WAY
SANTA ROSA, CA 95407
Family Medicine
2240 MERCURY WAY
SANTA ROSA, CA 95407
Internal Medicine
2240 MERCURY WAY
SANTA ROSA, CA 95407
Pharmacy (Community/Retail Pharmacy)
2240 MERCURY WAY, FL 1 MOB 6
SANTA ROSA, CA 95407
Family Medicine
2240 MERCURY WAY
SANTA ROSA, CA 95407

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 Katherine Pettibone's NPI number?

The NPI number for Katherine Pettibone is 1740773035. It was assigned to this individual provider in the NPPES registry on June 11, 2018.

Where is Katherine Pettibone located?

Katherine Pettibone practices at 2240 Mercury Way, Santa Rosa, CA 95407. The listed phone number is (707) 570-3120.

What is Katherine Pettibone's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Katherine Pettibone enrolled in Medicare?

Yes. Katherine Pettibone 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.

When was this NPI record last updated?

The NPPES record for Katherine Pettibone was last updated on April 6, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.