Eitan Homa, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

165 Lynch Creek Way
Petaluma, CA 94954-2343

Phone

(707) 762-5531

Fax

(707) 762-5976

NPI assigned

Oct 19, 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 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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eitan Homa MD and Jennifer Krasnoff MD IncGroup PAC ID 5890735856, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.59 of 100Reported as group

Quality

100

Improvement activities

40

Cost

81.98

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Eitan Homa MD and Jennifer Krasnoff MD Inc

  dba Dermatology Associates of the Bay Area

  • Dermatology Physician
  • Hercules, CA
  • NPI 1164514881
  Medicare reassignment Care Compare group NPD
• Eitan Homa and Jennifer Krasnoff MD Inc

  • Dermatology Physician
  • Petaluma, CA
  • NPI 1891821427
  NPD Authorized official
• California Pacific Medical Group, Inc.

  dba Brown & Toland Medical Group

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)
• SRM Alliance Hospital Services

  dba Petaluma Valley Hospital

  • Skilled Nursing Facility
  • Petaluma, CA
  • NPI 1770703886
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1326120718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALFRED NOBEL DR",
            "address_2": "SUITE 245",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945471838",
            "telephone_number": "510-741-7299",
            "fax_number": "510-741-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 LYNCH CREEK WAY",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542343",
            "telephone_number": "707-762-5531",
            "fax_number": "707-762-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMA",
        "first_name": "EITAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "070012651",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "A64754",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Holden
• Holistic ABA Inc
• Cynthia Virginia Hollins, C.M.T.
• Sarah Roseanne Hollister, RN, IBCLC
• Scott Holmes, D.O.
• Homebody Midwifery
• Hope Counseling Services
• Jerry W Horner II, HEALTH SERVICES TECH
• Sarah Hornstein, CD(DONA), CLS
• Samuel Walter Horton, DDS

• Specialist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.