Karen Gelphman, MD
NPI 1972565703 · Family Medicine Physician · Santa Rosa, CA
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Karen Gelphman, MD is a Family Medicine Physician provider in Santa Rosa, CA (NPI 1972565703).
Provider details
- NPI number
- 1972565703
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- G78072 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
20 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
49 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 37 | $139 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 12 | $99 |
Typical Medicare-allowed amounts for these services range $99–$139 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 2 distinct drugs on file.
| Drug | Part D claims (2024) |
|---|---|
| Atorvastatin Calcium | 18 |
| Sertraline Hcl | 12 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Additional practice locations (1)
- 131 Stony Cir Ste 1600Santa Rosa, CA 95401-9520Phone: (707) 541-7700Fax: (707) 573-5415
Registry dates
- Enumerated
- 2006-04-05
- Last updated
- 2023-03-07
- Certified
- 2020-03-17
Frequently asked questions
- What is Karen Gelphman's NPI number?
- Karen Gelphman's National Provider Identifier (NPI) is 1972565703, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Karen Gelphman's specialty?
- Karen Gelphman is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Karen Gelphman located?
- Karen Gelphman's practice location on file with NPPES is 3883 Airway Dr Ste 202, Santa Rosa, CA 95403-1671.
- What is Karen Gelphman's phone number?
- The practice phone number listed in the NPPES registry for Karen Gelphman is (707) 521-7777.
- Does Karen Gelphman accept Medicare?
- Karen Gelphman is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Karen Gelphman's NPI active?
- Yes — Karen Gelphman's NPI (1972565703) is active in the NPPES registry as of the last update on 2023-03-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.