Individual provider Active NPI

Todd Baumbacher, MD

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1053579987
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A109869 Issued in CA
Practice address
200 W Arbor Dr
#8819
San Diego, CA 92103-9001
Phone
(619) 543-6213
NPI assigned
May 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A109869 CA Primary
Emergency Medicine Physician 207P00000X 46513 AZ

Addresses

Primary practice location

200 W Arbor Dr
#8819
San Diego, CA 92103-9001

Mailing address

200 W Arbor Dr
#8819
San Diego, CA 92103-9001
Phone (619) 543-6213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120817000099 CA Practitioner - Emergency Medicine 2264688696 Reassigns benefits to 1 organization
I20120821000072 AZ Practitioner - Emergency Medicine 2264688696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Physicians of Northern California Medical Group IncGroup PAC ID 7113215146, 84 clinicians

Practice addresses (Care Compare)

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 465-0711

Hospital & facility affiliations

  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109869CAMDMarriage & Family Therapist
46513AZMDEmergency Medicine Physician
A109869CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Team Physicians of Northern California Medical Group Inc Emergency Medicine CurrentSince Aug 19, 2016 Accepting new patients
Cep America- Arizona, PC Emergency Medicine Current Accepting new patients
Pacific Emergency Providers, a Prof. Corp. Emergency Medicine Past Accepting new patients

Locations

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1053579987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "#8819",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039001",
            "telephone_number": "619-543-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "#8819",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039001",
            "telephone_number": "619-543-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMBACHER",
        "first_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A109869",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "46513",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.