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EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP INC
NPI 1295729382
Ophthalmology in Sebastopol, CA

Active since September 06, 2005CLIA 05D1077728 · Certificate of Compliance
6880 PALM AVE, SEBASTOPOL, CA 95472(707) 823-7628(707) 823-1521 Get Directions Write a Review

NPPES record last updated: September 1, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 1, 2020, Jan 23, 2020 (2 updates tracked since 2020).

About Eye Associates Of Sebastopol Medical Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP INC (NPI 1295729382) is a healthcare organization registered as an ophthalmology in Sebastopol, California and active in the NPI registry since September 2005. The organization holds a CLIA Certificate of Compliance certificate valid through September 24, 2026 and lists Kim Khamthee, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1295729382
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameEYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP INC
Location Address6880 PALM AVESebastopol, CA 95472-4270
Mailing Address6880 Palm AveSebastopol, CA 95472-4270 · (707) 823-7628 · Fax (707) 823-1521
Phone(707) 823-7628
Fax(707) 823-1521
Organization SubpartNo
Authorized OfficialKim KhamtheeBilling Manager · (707) 823-0229
Enumeration DateSeptember 6, 2005
Last NPPES UpdateSeptember 1, 20202 updates tracked since enumeration
NPPES CertifiedAugust 21, 2020
✔ NPI 1295729382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Definition
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.
6880 PALM AVE, Sebastopol, CA 95472
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Other Identifiers 9

MedicaidGR0083382CA
Other05D1077728CA · Clia
OtherZZZ88771ZCA · Blue Shield
MedicaidGR0083381CA
MedicaidGR0083383CA
MedicaidGR0083380CA
OtherZZZ16441ZCA · Blue Shield
Other1247100001CA · Dmerc
OtherCI4202CA · Medicare Ret Railroad

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D1077728

Eye Associates Of Sebastopol Medical Group, Inc · Sebastopol, CA
Active · expires Sep 24, 2026
CLIA Number05D1077728
Laboratory TypePhysician Office
Certificate Effective DateSeptember 25, 2024
Certificate Expiration DateSeptember 24, 2026
Laboratory DirectorAnya E. Bandt
Laboratory Phone(707) 823-7628
Laboratory LocationEye Associates Of Sebastopol Medical Group, Inc6880 Palm Ave, Sebastopol, CA 95472
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Medical Equipment Supplier Medicare DMEPOS 3

Medicare supplier enrollment and the product categories Eye Associates Of Sebastopol Medica carries, from the Medicare DMEPOS supplier directory.

Eye Associates Of Sebastopol Medica

DMEPOS supplier · Sebastopol, CAOperated by Eye Associates Of Sebastopol Medical Group
✔

Accepts Medicare assignment

Eye Associates Of Sebastopol Medica agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20635853
Medicare Participant SinceDecember 2, 1998
Supplier Location6880 Palm AveSebastopol, CA 95472
Phone(707) 823-7628
Provider TypePhysician – Ophthalmology
Supplier Specialties
Optometrist Optician

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Prosthetic Lenses: Prosthetics Cataract Lenses
Cataract Eyeglasses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARY LECHNER O.D.
Optometrist
6880 PALM AVE
SEBASTOPOL, CA 95472
Sonoma County (707) 994-8644
SEBASTOPOL ASC, L.P.
Clinic/Center (Ambulatory Surgical)
6880 PALM AVE
SEBASTOPOL, CA 95472
Sonoma County (707) 823-7628
DR. KENNETH ECONOMY MD
Anesthesiology
6880 PALM AVE
SEBASTOPOL, CA 95472
Sonoma County (707) 823-7628
DR. GREGORY ALLEN PERRONE O.D.
Optometrist
6880 PALM AVE
SEBASTOPOL, CA 95472
Sonoma County (707) 823-7628
DR. ERIC J KAHLE M.D.
Ophthalmology
6880 PALM AVE
SEBASTOPOL, CA 95472
Sonoma County (707) 823-7625
EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP
Eyewear Supplier
6880 PALM AVE
SEBASTOPOL, CA 95472
Sonoma County (707) 823-7628
OREOLUWA I OGUNYEMI M.D.
Urology
6880 PALM AVE
SEBASTOPOL, CA 95472
Sonoma County (707) 823-7628
KARIN N BOEHM O.D.
Optometrist
6880 PALM AVE
SEBASTOPOL, CA 95472
Sonoma County (707) 823-7628

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eye Associates Of Sebastopol Medical Group Inc's NPI number?

The NPI number for Eye Associates Of Sebastopol Medical Group Inc is 1295729382. It was assigned to this organization in the NPPES registry on September 6, 2005.

Where is Eye Associates Of Sebastopol Medical Group Inc located?

Eye Associates Of Sebastopol Medical Group Inc is located at 6880 Palm Ave, Sebastopol, CA 95472. The listed phone number is (707) 823-7628.

What is Eye Associates Of Sebastopol Medical Group Inc's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Eye Associates Of Sebastopol Medical Group Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Eye Associates Of Sebastopol Medica accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Eye Associates Of Sebastopol Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D1077728) is associated with this NPI, valid through September 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Eye Associates Of Sebastopol Medical Group Inc was last updated on September 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.