Scott W. Eberle, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G607087 Issued in CA

Practice address

416 Payran St
Petaluma, CA 94952-5907

Phone

(707) 778-6242

Fax

(707) 778-0144

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184681165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N FAIR ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522539",
            "telephone_number": "707-778-3412",
            "fax_number": "707-778-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 PAYRAN ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949525907",
            "telephone_number": "707-778-6242",
            "fax_number": "707-778-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLE",
        "first_name": "SCOTT",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G607087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00607870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Durham
• Victoria Ashley Grace Dwyer
• Eam&Co Services LLC
• Wesley Easley
• Jeff Eaton, BCBA
• Juan Echeverria
• Kaila Alexandra Eddy-Cooke
• Johnna Marie Edmunds, FNP
• Philippe Edouard, MD
• Marina Elizabeth Eggleston

• Family Medicine Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.