UNKNOWN MAR KAW SHU WA FNP
NPI 1669720629
Nurse Practitioner - Family in Santa Rosa, CA
About Unknown Mar Kaw Shu Wa Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
UNKNOWN MAR KAW SHU WA FNP (NPI 1669720629) is an individual family provider in Santa Rosa, California, licensed in California (95037014) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Unknown Mar Kaw Shu Wa Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Unknown Mar Kaw Shu Wa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Santa Rosa, CA 95403
- Reassigned Medicare billing, California enrollment
- 215 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SANTA ROSA, CA 95403
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 Unknown Mar Kaw Shu Wa's NPI number?
The NPI number for Unknown Mar Kaw Shu Wa is 1669720629. It was assigned to this individual provider in the NPPES registry on August 24, 2012. The provider is also known as Markawshuwa Mar Kaw Shu Wa Fnp.
Where is Unknown Mar Kaw Shu Wa located?
Unknown Mar Kaw Shu Wa practices at 3569 Round Barn Cir, Santa Rosa, CA 95403. The listed phone number is (707) 303-3600.
What is Unknown Mar Kaw Shu Wa's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Unknown Mar Kaw Shu Wa enrolled in Medicare?
Yes. Unknown Mar Kaw Shu Wa is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Unknown Mar Kaw Shu Wa's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Unknown Mar Kaw Shu Wa reassigns Medicare benefits to Santa Rosa Community Health Centers (Santa Rosa, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Unknown Mar Kaw Shu Wa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Unknown Mar Kaw Shu Wa was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.
# Unknown Mar Kaw Shu Wa, FNP · NPI 1669720629
Family physician in Santa Rosa, California. Individual provider, active in the CMS NPPES registry since August 24, 2012.
## Identity
- **NPI:** 1669720629 (Entity type: Individual)
- **Enumerated:** August 24, 2012
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95037014 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3569 ROUND BARN CIR, Santa Rosa, CA 95403-5781
- **Phone:** (707) 303-3600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Santa Rosa Community Health Centers (NPI 1578631172, Santa Rosa, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** November 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1669720629) · Data from the CMS NPPES public registry.