DR. WILLIAM JORNLIN (MD) – Family Medicine Physician, NPI 1235112160

DR. WILLIAM JORNLIN (MD) is a healthcare provider. based in Roseville, California. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. A064104 (CA). The NPI Number for DR. WILLIAM JORNLIN (MD) is 1235112160

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
DR. WILLIAM JORNLIN (MD)
NPI
1235112160
Phone
(916) 783-7109
Address
2261 DOUGLAS BLVD
Enumeration Date
23 November 2005
Last Update Date
29 November 2007

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Secondary Phone
5308872800
Graduation Year
1996 (30 years ago)
PAC ID
3779644638
Group Practice PAC ID
4981688520
Professional Enrollment ID
I20081210000524
Address ID
CA956039522AU11670RDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

13,194 FAMILY PRACTICE in CA

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Provider Addresses for DR. WILLIAM JORNLIN (MD)

  • 2261, Douglas Boulevard, Roseville, Placer County, California, 95661, United States

    ROSEVILLE, CA 956613831

    Phone: (916) 783-7109

    Fax: (916) 783-3070

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-12-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081210000524IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95661)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981688520View full group profile
NameSpecialtyState
Psychiatry, NeurologyFL
Nurse PractitionerCA
Nurse PractitionerCA
Clinical Social WorkerCA
Nurse PractitionerCA
Nurse PractitionerCA
Family PracticePA
Family PracticeCA
O P T O M E T R YNY
Family PracticeCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. WILLIAM JORNLIN (MD)?
DR. WILLIAM JORNLIN (MD) — NPI 1235112160 — is the standard way to identify this listing.
Is DR. WILLIAM JORNLIN (MD) listed as active for patients and plans?
The listing shows DR. WILLIAM JORNLIN (MD) as active in the NPI system.
What taxonomy line describes DR. WILLIAM JORNLIN (MD)?
For research purposes, treat DR. WILLIAM JORNLIN (MD) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does DR. WILLIAM JORNLIN (MD) serve?
DR. WILLIAM JORNLIN (MD)'s listing highlights Roseville, California; more addresses can appear in NPPES.
Is the information about DR. WILLIAM JORNLIN (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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