Individual provider Active NPI

Roger Dana Weeks, M.D.

  • Ophthalmology Physician
  • Petaluma, CA
National Provider Identifier
1235157611
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A24319 Issued in CA
Practice address
47 Maria Dr
Suite 814
Petaluma, CA 94954-3560
Phone
(707) 762-7328
Fax
(707) 762-0614
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A24319 CA Primary

Addresses

Primary practice location

47 Maria Dr
Suite 814
Petaluma, CA 94954-3560

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
00A243190MedicaidCA

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
I20100706000493 CA Practitioner - Ophthalmology 5395876445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, San Francisco School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Petaluma Health Center IncGroup PAC ID 9133180375, shared by 8 NPIs, 76 clinicians

Practice addresses (Care Compare)

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

1310 Prentice Dr
Suite F
Healdsburg, CA 95448-5004
Phone (707) 433-9475

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A24319CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Bay Eye Associates a Medical Corporation CurrentSince Sep 1, 2014 Accepting new patients
North Bay Eye Associates a Medical Corporation Ophthalmology CurrentSince Sep 1, 2014 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Petaluma Health Center Inc Past Accepting new patients
Petaluma Health Center Inc Past Accepting new patients
SRM Alliance Hospital Services Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Locations

1310 Prentice Dr
Ste F
Healdsburg, CA 95448
Phone (707) 433-9475

225 S Main St
Lakeport, CA 95453
Phone (707) 263-0101

104 Lynch Creek Way
Ste 15
Petaluma, CA 94954
Phone (707) 762-3573

Interoperability endpoints

  • Direct secure messaging: rweeks614169@direct.ochin.org

Organizations & group practices 8

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.

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1235157611",
    "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",
            "fax_number": "707-559-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MARIA DR",
            "address_2": "SUITE 814",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949543560",
            "telephone_number": "707-762-7328",
            "fax_number": "707-762-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEKS",
        "first_name": "ROGER",
        "middle_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A24319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A243190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.