NAOMI HAN (PA) – Physician Assistant, NPI 1407505530
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Provider Addresses for NAOMI HAN (PA)
360 SUNDANCE AVE
VALLEJO, CA 945921170
Phone: (510) 847-1638
Type: Mailing
1310 CLUB DR
VALLEJO, CA 945921187
Phone: (707) 638-5200
Type: Location
2011 MANCHESTER RD
SAN LEANDRO, CA 945781435
Phone: (510) 929-7172
Type: Mailing
1200 CENTRAL BLVD STE D
BRENTWOOD, CA 945132227
Phone: (925) 308-9510
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251103003931 | I | Physician Assistant | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 94592)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WI | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| O T O L A R Y N G O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| Physician Assistant | CA | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| Physician Assistant | GA |
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