James A Shubin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G32561 Issued in CA

Practice address

7410 Blossomwood Ave
Sebastopol, CA 95472-4345

Phone

(707) 569-4897

NPI assigned

Oct 11, 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 1

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

Specialty

Family Practice

Education

University of California, Davis School of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Round Valley Indian Health Center, Inc.Group PAC ID 9234128927, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Round Valley Indian Health Center, Inc.

  • Clinic/Center
  • Covelo, CA
  • NPI 1669532750

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Round Valley Indian Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Covelo, CA
  • NPI 1114136066
  NPD (past)
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1295723518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 BLOSSOMWOOD AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724345",
            "telephone_number": "707-569-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 BLOSSOMWOOD AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724345",
            "telephone_number": "707-569-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBIN",
        "first_name": "JAMES",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G32561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G325610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ally Shamseldin
• Marisa Shanahan
• Shannon Coon BSN
• Jessie Rose Shepherd, MFTI
• Britta Shiels, LMFT
• Matthew Tomasz Shubin, LMFT
• Sharon Siegler
• Amanda Silva, LCSW
• Brittany Silva
• Harry S. Simms, MD

• Family Medicine Physician in Sebastopol, CA
• Providers in Sebastopol, 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 Dec 26, 2019; 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.