Mitchell Edward Bailey, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G25349 Issued in CA

Practice address

30 Mark West Springs Rd
Santa Rosa, CA 95403-1436

Phone

(707) 328-9673

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mitchell_bailey_md_surgeon@yourcarecommunity.org

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1366422008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 W SAHARA AVE # 118",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175744",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MARK WEST SPRINGS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031436",
            "telephone_number": "707-328-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "MITCHELL",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G25349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G253490",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00270015",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00G253490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lia Marie Bahls, PMHNP-BC
• Harold Joseph Bahr
• Nazneen Bahrassa, PH.D.
• James Andrew Bailey, MA, MFT
• Jeremy David Bailey, LCSW
• Ojaya Bailey
• Jeanne Bailly
• Gregory William Baird, DDS
• Jessica Baisley
• Agata Baker

• Surgery Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.