Individual provider Active NPI

Avni A Shah, MD

  • Glaucoma Specialist (Ophthalmology) Physician
  • Santa Rosa, CA
National Provider Identifier
1598007676
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X
License
A163015 Issued in CA
Practice address
3035 Cleveland Ave Ste 100
Santa Rosa, CA 95403-2122
Phone
(708) 623-8200
NPI assigned
Mar 26, 2013
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 269995 MA
Ophthalmology Physician 207W00000X A163015 CA
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X 269995 MA
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X A163015 CA Primary

Addresses

Primary practice location

3035 Cleveland Ave Ste 100
Santa Rosa, CA 95403-2122

Mailing address

3035 Cleveland Ave Ste 100
Santa Rosa, CA 95403-3037
Phone (707) 546-9800

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
I20190912001305 CA Practitioner - Ophthalmology 8628390416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Rutgers New Jersey Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3035 Cleveland Ave
Suite 100
Santa Rosa, CA 95403-3037
Phone (707) 546-9800

Merit-based Incentive Payment System (MIPS)

Final score
92.15 of 100Reported as group
Quality
95.66
Improvement activities
40
Cost
75.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery382

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A163015CAMDGlaucoma Specialist (Ophthalmology) Physician
269995MAMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Institute, a Medical Corporation Ophthalmology CurrentSince Sep 1, 2019 Accepting new patients
Eye Care Institute, a Medical Corporation Ophthalmology CurrentSince Sep 1, 2019 Accepting new patients
Tufts Medical Center, Inc. Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

1383 N McDowell Blvd
Ste 100
Petaluma, CA 94954
Phone (707) 763-6400

1017 2nd St
Santa Rosa, CA 95404
Phone (707) 546-9800

3035 Cleveland Ave
Ste 100
Santa Rosa, CA 95403
Phone (707) 545-3800

720 4th St
Santa Rosa, CA 95404
Phone (707) 544-3147

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1598007676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 CLEVELAND AVE STE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033037",
            "telephone_number": "707-546-9800",
            "fax_number": "707-899-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 CLEVELAND AVE STE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032122",
            "telephone_number": "708-623-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "AVNI",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "269995",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A163015",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "MA",
            "license": "269995",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "CA",
            "license": "A163015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.