Individual provider Active NPI

Aaron Michael Nayfack, MD

  • Developmental - Behavioral Pediatrics Physician
  • San Carlos, CA
National Provider Identifier
1407048598
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
G78133 Issued in CA
Practice address
301 Industrial Rd
San Carlos, CA 94070-2603
Phone
(650) 523-3960
NPI assigned
Aug 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A100829 CA
Developmental - Behavioral Pediatrics Physician 2080P0006X G78133 CA Primary

Addresses

Primary practice location

301 Industrial Rd
San Carlos, CA 94070-2603

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (408) 523-3960

Other practice location 1

370 Distel Circle
Los Altos, CA 94022-1404
Phone (650) 254-5200

Other identifiers 1

IdentifierTypeStateIssuer
A100829OtherCAMEDICAL BOARD OF CA

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
I20150819008886 CA Practitioner - Pediatric Medicine 3870808827 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100829CAMDPediatrics Physician
G78133CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Jul 27, 2015 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jul 27, 2015 Accepting new patients
County of Santa Clara Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

301 Industrial Rd
San Carlos, CA 94070
Phone (650) 596-4000

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: anayfack302526@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1407048598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "408-523-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 INDUSTRIAL RD",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702603",
            "telephone_number": "650-523-3960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 Distel Circle",
            "address_purpose": "LOCATION",
            "city": "Los Altos",
            "state": "CA",
            "postal_code": "940221404",
            "country_code": "US",
            "telephone_number": "650-254-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAYFACK",
        "first_name": "AARON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A100829",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "G78133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CA",
            "identifier": "A100829",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

Verify at the official NPI Registry.