Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael Leonce Pezold, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1720377856

Michael Leonce Pezold, MD is a Vascular Surgery in Santa Rosa, California. Graduated from University of Colorado School of Medicine, Denver in 2011, 15 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in California and New York.

Years since qualifying
15
Trained at
University of Colorado School of Medicine, Denver
Licensed in
CA, NY
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1162 Montgomery Dr Ste 300
Santa Rosa, CA 95405-4802
Phone: (707) 890-4250
Fax: (707) 476-2240
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 550 1st Ave, New York, NY 10016-6402 — (212) 263-5506
  • 525 E 68th St, New York, NY 10065-4870 — (212) 746-5380

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence A168740 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 276415 (NY)

Record details

NPI number1720377856
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 29, 2011
Last updated in NPPESAugust 28, 2025
Certification dateAugust 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyVASCULAR SURGERY
Also practisesGENERAL SURGERY
Medical schoolUNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
Graduated 2011 (15 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Santa Rosa