Individual provider Active NPI

Ali Sina Bari, M.D.

  • Plastic Surgery Physician
  • Pinole, CA
National Provider Identifier
1184884116
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A104654 Issued in CA
Practice address
2300 Henry Ave
Pinole, CA 94564-1714
Phone
(510) 984-1103
Fax
(888) 628-9895
NPI assigned
Jun 12, 2008
Last updated
Jul 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A104654 CA Primary
Surgery Physician 208600000X PENDING CA

Addresses

Primary practice location

2300 Henry Ave
Pinole, CA 94564-1714

Mailing address

PO Box 6671
Santa Rosa, CA 95406-0671
Phone (707) 473-0220

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
I20130719000252 CA Practitioner - Plastic and Reconstructive Surgery 5496996365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Stanford University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SNF Specialists Medical CorporationGroup PAC ID 3678849049, 26 clinicians

Practice addresses (Care Compare)

1255 Travis Blvd
Fairfield, CA 94533-4801
Phone (800) 973-1540

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A104654CAMDPlastic Surgery Physician
PENDINGCAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SNF Specialists Medical Corporation CurrentSince May 15, 2021 Accepting new patients

Locations

1255 Travis Blvd
Fairfield, CA 94533
Phone (707) 425-0623

2300 Henry Ave
Pinole, CA 94564
Phone (510) 847-0879

Organizations & group practices 1

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1184884116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6671",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954060671",
            "telephone_number": "707-473-0220",
            "fax_number": "707-473-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HENRY AVE",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641714",
            "telephone_number": "510-984-1103",
            "fax_number": "888-628-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARI",
        "first_name": "ALI",
        "middle_name": "SINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A104654",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "PENDING",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

Verify at the official NPI Registry.