Hollis Loren Stavn, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6812T Issued in CA

Practice address

2305 Mendocino Ave
Ste B
Santa Rosa, CA 95403-3157

Phone

(707) 527-9137

Fax

(707) 545-9278

NPI assigned

May 31, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Bay Eye Associates, a Medical CorporationGroup PAC ID 9436147980, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• North Bay Eye Associates a Medical Corporation

  • Ophthalmology Physician
  • Rohnert Park, CA
  • NPI 1952418378
  Medicare reassignment Care Compare group NPD
• North Bay Eye Associates a Medical Corporation

  • Ambulatory Surgical Clinic/Center
  • Santa Rosa, CA
  • NPI 1073620415
  NPD

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1194728527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 MENDOCINO AVE",
            "address_2": "STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033157",
            "telephone_number": "707-527-9137",
            "fax_number": "707-545-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 MENDOCINO AVE",
            "address_2": "STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033157",
            "telephone_number": "707-527-9137",
            "fax_number": "707-545-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVN",
        "first_name": "HOLLIS",
        "middle_name": "LOREN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6812T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAGEGUARD",
            "identifier": "45719",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0068121",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Starbuck
• Stephen Starkweather
• Sadie Blue Lucia Starrett
• Sarah Stassi, MD
• Bailey Elyse Staton
• George D Staykow, PHARMD
• Steady Steps Home LLC
• Kenya Steele-Terry
• Daniel Robert Steele
• Don Carlos Steele

• Optometrist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.