NPIMap

Individual provider Active NPI

Edward Bocc, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Petaluma, CA
National Provider Identifier
1215014469
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18351 Issued in CA
Practice address
1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone
(707) 559-7500
NPI assigned
Nov 1, 2006
Last updated
May 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18351 CA Primary

Addresses

Primary practice location

1179 N McDowell Blvd
Petaluma, CA 94954-6559

Mailing address

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500

Other practice location 1

1381 University Ave
Healdsburg, CA 95448-3314
Phone (707) 431-8234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150508000817 CA Practitioner - Physician Assistant 7012170103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Petaluma Health Center IncGroup PAC ID 9133180375, 76 clinicians
Coastal Health AllianceGroup PAC ID 7315919933, 40 clinicians

Practice addresses (Care Compare)

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500

5900 State Farm Dr
Suite 200
Rohnert Park, CA 94928-2149
Phone (707) 559-7600

PO Box
Suite 910
Point Reyes Station, CA 94956-0910

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.9 of 100Reported as group
Quality
81.89
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18351CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Petaluma Health Center, Inc CurrentSince Jun 16, 2025 Accepting new patients
Alliance Medical Center CurrentSince Aug 19, 2004 Accepting new patients
Petaluma Health Center Inc CurrentSince Jun 16, 2025 Accepting new patients
Alliance Medical Center CurrentSince Aug 19, 2004 Accepting new patients

Locations

1381 University St
Healdsburg, CA 95448
Phone (707) 431-8234

1179 N McDowell Blvd
Petaluma, CA 94954

Interoperability endpoints

  • Direct secure messaging: ebocc26545@direct.ochin.org
  • Direct secure messaging: ebocc800726@direct.ochin.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1215014469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1381 University Ave",
            "address_purpose": "LOCATION",
            "city": "Healdsburg",
            "state": "CA",
            "postal_code": "954483314",
            "country_code": "US",
            "telephone_number": "707-431-8234",
            "fax_number": "707-431-8649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOCC",
        "first_name": "EDWARD",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.