EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP INC
NPI 1295729382
Ophthalmology in Sebastopol, CA
NPI Status: Active since September 06, 2005
Contact Information
6880 PALM AVE
SEBASTOPOL, CA
ZIP 95472
Phone: (707) 823-7628
Fax: (707) 823-1521
- Organization
- Ophthalmology
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 05D1077728
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-24-2026
About EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP INC
This page provides the complete NPI Profile along with additional information for Eye Associates Of Sebastopol Medical Group Inc, a provider established in Sebastopol, California operating as a Ophthalmology. The healthcare provider is registered in the NPI registry with number 1295729382 assigned on September 2005. The practitioner's primary taxonomy code is 207W00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Eye Associates Of Sebastopol Medical Group Inc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Ms. Kim Khamthee (Billing Manager)
- NPI
- 1295729382
- Provider Name
- EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP INC
- Entity Type
- Organization
- Location Address
- 6880 PALM AVE SEBASTOPOL, CA 95472
- Location Phone
- (707) 823-7628
- Location Fax
- (707) 823-1521
- Mailing Address
- 6880 PALM AVE SEBASTOPOL, CA 95472
- Mailing Phone
- (707) 823-7628
- Mailing Fax
- (707) 823-1521
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-06-2005
- Last Update Date
- 09-01-2020
- Code Navigator
Ophthalmologists like Eye Associates Of Sebastopol Medical Group Inc specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
Eye Associates Of Sebastopol Medical Group Inc is a medicare supplier with PTAN 20635853 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses or Prosthetic Lenses: Prosthetics Cataract Lenses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| GR0083382 | MEDICAID (05) | CA | |
| 05D1077728 | OTHER (01) | CA | CLIA |
| ZZZ88771Z | OTHER (01) | CA | BLUE SHIELD |
| GR0083381 | MEDICAID (05) | CA | |
| GR0083383 | MEDICAID (05) | CA | |
| GR0083380 | MEDICAID (05) | CA | |
| ZZZ16441Z | OTHER (01) | CA | BLUE SHIELD |
| 1247100001 | OTHER (01) | CA | DMERC |
| CI4202 | OTHER (01) | CA | MEDICARE RET RAILROAD |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20635853
- Accepts Medicare Assignment
- YES
- Specialities List
- Optometrist, Optician.
- Provider Type List
- PHYSICIAN – OPHTHALMOLOGY.
- Competitive Bidding
- NO
Supplies List
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
- Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D1077728
- Facility Type
- Physician Office
- Certificate Effective Date
- September 25, 2024
- Certificate Expiration Date
- September 24, 2026
- Laboratory Director
- ANYA E. BANDT
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Eye Associates Of Sebastopol Medical Group Inc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1295729382, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295729382, enumerated as an "organization" on September 06, 2005.
The provider is located at 6880 PALM AVE SEBASTOPOL, CA 95472 and the phone number is (707) 823-7628.
Ophthalmology with taxonomy code 207W00000X.
The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.
