About Us

When Dr. Thomas Paukert, a nephrologist, married Sheryle Paukert, a nurse practitioner, they decided to partner in their mission to provide quality health care to Napa residents. This unique practice combines specialty care for people with kidney disease and primary care for anyone age 18 and up. The nephrologists also provide care at dialysis centers and regional hospitals, while the primary care providers deliver a range of general medical services in the office setting.


Nephrologists provide specialty care for patients with kidney disease, including those on dialysis.

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Internal Medicine

Primary care providers are your first point of contact with the health care system, whether you have a new issue or need help managing a chronic health condition.

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Support Staff

Our staff are available to assist you in scheduling an appointment or answering any questions you may have.

Meet out staff



phone: 707-252-8407   •   fax: 707-252-8335   •   email: nvna59@gmail.com

hours: Monday-Thursday 9am-5pm, open until 1pm on Fridays

Support Staff

summary of Practice Policies

We accept Medicare, Medi-Cal, Partnership, Blue Cross Blue Shield, and more. Call us to make sure we accept your particular plan when scheduling an appointment.

If you have a question regarding your insurance or billing statement, we will be happy to answer your questions and provide any necessary assistance. Co-pays are due at the time of service. Outstanding balances may be paid by credit card, check, or cash.

We ask that if you are unable to keep an appointment, you give 24 hours' notice. By doing so, you allow another patient to use that appointment slot. Missing an appointment or cancelling less than 24 hours in advance will result in a $50 no show fee.

On-call services are available after business hours, 7 days a week for emergencies. Please call 707-252-8407 and one of our physicians will be contacted right away. If you feel you are having a life-threatening emergency, you should always immediately call 911. We offer same day appointments for urgent issues. Please call first thing in the morning if possible so we can try to fit you into the schedule for the day.

Medication refills
To refill a medication, call your pharmacy. If your medication needs to be reviewed by a provider before being refilled, you may be asked to come in for an appointment or have labs done to make sure the medication is still safe and appropriate for you. Always refill medications at least a week before they run out to allow enough time for your pharmacy and provider to process the refill request. If you use a mail service for your prescriptions, allow at least two weeks.

Prior Authorizations
A treatment authorization request or prior authorization may be required by your insurance company for some tests or medications. If your provider orders a medication or test that is not typically covered by your insurance, our staff will work with your insurance company to try to get the requested service covered for you.

Referrals to Specialists
In the event your provider determines coordination with a specialist would be helpful in managing your care, you may be referred to a specialist either for a consultation visit or for another provider to manage a particular health condition. Nationally, only 5% of primary care visits result in a referral because most acute and chronic conditions can be managed in the office setting. The determination of whether a referral is appropriate is up to the individual clinician. This decision is based on the complexity of the medical issue, the resources available in the primary care setting for evaluation or management of the condition, and the relevant experience of the individual clinician. Our referral coordinator will work with your insurance to ensure your visit will be covered. This process may take up to two weeks depending on your insurance and the urgency of the health condition.

Completing applications for assisted living facilities, durable medical equipment, or family medical leave (FMLA) can require a considerable amount of a provider's time to complete. A $50 fee may be changed for paperwork.

The Health Insurance Portability and Accountability Act of 1996 keeps your health records and personal health information private. Unless you make a specific request for your health records to be shared, information about your health will only be shared between healthcare professionals who are working together to care for you.