Sonoma Specialty Hospital, LLC

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

Legal business name

SONOMA SPECIALTY HOSPITAL, LLC

Practice address

501 Petaluma Ave
Sebastopol, CA 95472-4215

Phone

(707) 823-8511

NPI assigned

Mar 20, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Tammy Jean Thompson

Title

Cfo VP Finance/Operations

Phone

(209) 248-7851

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospital certification: CCN 052057

Legal name

SONOMA SPECIALTY HOSPITAL, LLC

Certification status

Active

Provider type (POS)

Hospital – Long-term

Participating since

Apr 1, 2019

Last certification

Jun 20, 2024

Beds

58 (37 certified)

Ownership / control type

Private (for profit)

Organization structure

LLCProprietary

Incorporated

Aug 8, 2018 in CA

Enrollment address

501 Petaluma Ave
Sebastopol, CA 95472-4215
Main/Primary Hospital Location

Hospital subgroups

Acute care, Long-term

Hospital certification: CCN 050781

Legal name

SONOMA SPECIALTY HOSPITAL

Certification status

Terminated Other: provider status change, Mar 31, 2019

Provider type (POS)

Hospital – Short-term

Participating since

Dec 17, 2015

Last certification

Dec 17, 2015

Beds

37

Ownership / control type

Local

Most recent change of ownership

Apr 1, 2019 (1 total)

Facility address

501 Petaluma Avenue
Sebastopol, CA 95472

Listed as

Sonoma Specialty HospitalCCN 052057 · All quality measures

Ownership

For profit

Certified

Apr 1, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Beds

37

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Gurpreet Singh, MD

  • Gastroenterology Physician
  • Turlock, CA
  • NPI 1194780999

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mujeeb Altaf, MBBS.,MRCP(UK)

  • Hospitalist Physician
  • Santa Rosa, CA
  • NPI 1316125941

  Long-term care hospital

  Care Compare affiliation
• Naseer Ibraheem Jameel

  • Internal Medicine Physician
  • Santa Rosa, CA
  • NPI 1518378413

  Long-term care hospital

  Care Compare affiliation
• Jan O Sonander, MD

  • Family Medicine Physician
  • Santa Rosa, CA
  • NPI 1982763959

  Long-term care hospital

  Care Compare affiliation
• Vishnuvardhan Reddy Komari, M.D.

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1790929966

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1396205050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PETALUMA AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724215",
            "telephone_number": "707-823-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PETALUMA AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724215",
            "telephone_number": "707-823-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA SPECIALTY HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CFO VP FINANCE/OPERATIONS",
        "authorized_official_telephone_number": "209-248-7851",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anya Rose Soled, OTR/L
• Donald Alan Solomon, M.D.
• Ellen K Solot, M.A
• Chelsey Souza
• Krista Spangler, LMFT
• Speech Language and Learning Services of Northern California, LLC
• Sage Staggs, L.AC.
• Tina Stanley, L.C.S.W.

• Long Term Care Hospital in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Long Term Care Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.