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

Myles Julian Ketchum, MD, PHD

Individual provider Addiction Medicine (Preventive Medicine) Physician · NPI 1093249864

Myles Julian Ketchum, MD, PHD is registered under Family Practice in Santa Rosa, California. Graduated from Louisiana State University School of Medicine in New Orleans in 2017, 9 years ago. Practices with Shasta Community Health Center, a 63-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
9
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
CA
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

2360 Mendocino Ave
Santa Rosa, CA 95403-3153
Phone: (707) 573-5250
Fax: (707) 573-5458
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Family Medicine) Physician (primary) Taxonomy 207QA0401X · Licence 1211497 (CA)
Addiction Medicine (Preventive Medicine) Physician Taxonomy 2083A0300X · Licence 61-25999 (CA)

Record details

NPI number1093249864
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , PHD
Sole proprietorYes
NPI enumeratedApril 18, 2017
Last updated in NPPESMay 27, 2025
Certification dateMay 27, 2025

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2017 (9 years in practice)
Group practice Shasta Community Health Center — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients97
Services billed 174 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Shasta Community Health Center

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 63 clinicians in the practice; 12 are shown here.