Individual provider Active NPI

Anthony F Soria, OD

  • Optometrist
  • Santa Rosa, CA
National Provider Identifier
1346219755
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9925T Issued in CA
Practice address
3569 Round Barn Cir
Santa Rosa, CA 95403-5781
Phone
(707) 303-3600
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9925T CA Primary

Addresses

Primary practice location

3569 Round Barn Cir
Santa Rosa, CA 95403-5781

Mailing address

640 Healdsburg Ave
Healdsburg, CA 95448-3609
Phone (707) 433-5020

Other identifiers 1

IdentifierTypeStateIssuer
SD0099250MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120314000336 CA Practitioner - Optometry 4183755507 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9925TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers CurrentSince Apr 1, 2024 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Apr 1, 2024 Accepting new patients
Santa Rosa Community Health Centers Current Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

3569 Round Barn Cir
Santa Rosa, CA 95403

Interoperability endpoints

  • Direct secure messaging: asoria627837@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1346219755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 HEALDSBURG AVE",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483609",
            "telephone_number": "707-433-5020",
            "fax_number": "707-433-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035781",
            "telephone_number": "707-303-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORIA",
        "first_name": "ANTHONY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9925T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0099250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.