CHARLENE CROCKETT MD
NPI 1720379316
Ophthalmology in Santa Rosa, CA
About Charlene Crockett Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHARLENE CROCKETT MD (NPI 1720379316) is an individual ophthalmology provider in Santa Rosa, California, licensed in California (191905) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS and is a graduate of Baylor College Of Medicine (2010).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Charlene Crockett Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Charlene Crockett reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Vallejo, CA 94589
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Houston, TX 77025
- Reassigned Medicare billing, Texas enrollment
- 1,649 clinicians in this Medicare group
Houston, TX 77030
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Texas Childrens Physician Group
- 2,498 clinicians in this Medicare group
Houston, TX 77030
- Reassigned Medicare billing, Texas enrollment
- 2,554 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.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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 Charlene Crockett's NPI number?
The NPI number for Charlene Crockett is 1720379316. It was assigned to this individual provider in the NPPES registry on April 29, 2011.
Where is Charlene Crockett located?
Charlene Crockett practices at 3925 Old Redwood Hwy, Santa Rosa, CA 95403. The listed phone number is (707) 393-4033.
What is Charlene Crockett's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Charlene Crockett enrolled in Medicare?
Yes. Charlene Crockett is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Charlene Crockett's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Charlene Crockett reassigns Medicare benefits to 4 organizations: Permanente Medical Group Inc (Vallejo, CA), Kelsey-Seybold Medical Group, PLLC (Houston, TX), Texas Children's Physician Group (Houston, TX) and Baylor College Of Medicine (Houston, TX). Each 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 Charlene Crockett's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Charlene Crockett accept?
Health plans from Blue Cross and Blue Shield of Texas list Charlene Crockett as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Charlene Crockett was last updated on December 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Charlene Crockett, MD · NPI 1720379316
Ophthalmology physician in Santa Rosa, California. Individual provider, active in the CMS NPPES registry since April 29, 2011.
## Identity
- **NPI:** 1720379316 (Entity type: Individual)
- **Enumerated:** April 29, 2011
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **State license:** 191905 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3925 OLD REDWOOD HWY, Santa Rosa, CA 95403-1719
- **Phone:** (707) 393-4033
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Permanente Medical Group Inc (NPI 1336222397, Vallejo, CA); Kelsey-Seybold Medical Group, PLLC (NPI 1013915255, Houston, TX); Texas Children's Physician Group (NPI 1861675506, Houston, TX); Baylor College Of Medicine (NPI 1881026664, Houston, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Baylor College Of Medicine, class of 2010
## Record status
- **NPPES last updated:** December 18, 2023
- **Other identifiers:** Medicaid 349043503 (TX); Medicaid 349043505 (TX); Medicaid 349043504 (TX)
---
Source: [NPI Profile](https://npiprofile.com/npi/1720379316) · Data from the CMS NPPES public registry.