Individual provider Active NPI

Christianne Wa, MD

  • Retina Specialist (Ophthalmology) Physician
  • Vallejo, CA
National Provider Identifier
1073908976
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
A144991 Issued in CA
Practice address
1460 N Camino Alto Ste 206
Vallejo, CA 94589-2567
Phone
(800) 573-8462
Fax
(707) 552-9599
NPI assigned
Mar 30, 2015
Last updated
Mar 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A144991 CA
Ophthalmology Physician 207W00000X R75586 AZ
Retina Specialist (Ophthalmology) Physician 207WX0107X 4301117014 MI
Retina Specialist (Ophthalmology) Physician 207WX0107X A144991 CA Primary

Addresses

Primary practice location

1460 N Camino Alto Ste 206
Vallejo, CA 94589-2567

Mailing address

365 Lennon LN Ste 250
Walnut Creek, CA 94598-5915
Phone (800) 573-8462

Other practice location 1

4049 Lone Tree Way Ste Ij
Antioch, CA 94531-6202
Phone (800) 573-8462

Other practice location 2

491 30th St Ste 102
Oakland, CA 94609-3235
Phone (800) 573-8462

Other practice location 3

20130 Lake Chabot Rd Ste 303
Castro Valley, CA 94546-5340
Phone (800) 573-8462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713001896 CA Practitioner - Ophthalmology 8820353089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Retina AssociatesGroup PAC ID 8527956580, 8 clinicians

Practice addresses (Care Compare)

1460 N Camino Alto
Suite 206
Vallejo, CA 94589-2567
Phone (707) 552-9596

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R75586AZMDOphthalmology Physician
A144991CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Retina Associates, Medical Group Retina Specialist CurrentSince Oct 1, 2023 Accepting new patients
Bay Area Retina Associates Retina Specialist CurrentSince Oct 1, 2023 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
Capitol Urology Medical Group Inc Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
William Beaumont Hospital Past Accepting new patients
Carondelet Health Network Past Accepting new patients
John Muir Health Past Accepting new patients
Dignity Health Past Accepting new patients
Vitreo-Retinal Medical Group, Inc. Ophthalmology Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Northbay Healthcare Group Past Accepting new patients

Locations

4049 Lone Tree Way
Ste Ij
Antioch, CA 94531
Phone (800) 573-8462

20130 Lake Chabot Rd
Ste 303
Castro Valley, CA 94546
Phone (510) 733-1888

39055 Hastings St
Ste 105
Fremont, CA 94538
Phone (510) 505-1430

491 30th St
Ste 102
Oakland, CA 94609
Phone (510) 832-6554

5980 Stoneridge Dr
Ste 117
Pleasanton, CA 94588
Phone (925) 463-8200

15051 Hesperian Blvd
Ste D
San Leandro, CA 94578
Phone (510) 317-1111

2160 W Grant Line Rd
Ste 240
Tracy, CA 95377
Phone (209) 833-6118

1350 Burton Dr
Ste 210
Vacaville, CA 95687
Phone (707) 359-4642

1460 N Camino Alto
Ste 206
Vallejo, CA 94589
Phone (707) 552-9596

365 Lennon Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 627-3424

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cwa@bayarearetina.intellechartdirect.net
  • Direct secure messaging: cwa209396@hisp.ehr.sutterhealth.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1073908976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 LENNON LN STE 250",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985915",
            "telephone_number": "800-573-8462",
            "fax_number": "925-943-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 N CAMINO ALTO STE 206",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892567",
            "telephone_number": "800-573-8462",
            "fax_number": "707-552-9599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4049 Lone Tree Way Ste Ij",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "CA",
            "postal_code": "945316202",
            "country_code": "US",
            "telephone_number": "800-573-8462",
            "fax_number": "925-522-8851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "491 30th St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946093235",
            "country_code": "US",
            "telephone_number": "800-573-8462",
            "fax_number": "510-832-3119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20130 Lake Chabot Rd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Castro Valley",
            "state": "CA",
            "postal_code": "945465340",
            "country_code": "US",
            "telephone_number": "800-573-8462",
            "fax_number": "510-881-5332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WA",
        "first_name": "CHRISTIANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A144991",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "R75586",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MI",
            "license": "4301117014",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "A144991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.