Bay Area Esthetics Plastic Surgery Inc

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

BAY AREA ESTHETICS PLASTIC SURGERY INC

Practice address

1111 Sonoma Ave Ste 210
Santa Rosa, CA 95405-4833

Phone

(209) 339-8921

Fax

(415) 523-5235

NPI assigned

May 19, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Navid Pourtaheri, MD, PHDNPI 1942543681

Title

President and Secretary

Phone

(415) 523-5235

Specialties & licenses 2

Addresses

Other names 1

• Bay Area Esthetics Plastic Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Navid Pourtaheri, M.D., PH.D

  • Plastic Surgery Physician
  • San Francisco, CA
  • NPI 1942543681
  Medicare reassignment NPD Authorized official
• Melissa Ann Mueller, MD

  • Plastic Surgery Physician
  • San Francisco, CA
  • NPI 1861837148
  Medicare reassignment NPD
• Kelsey Nicole Thayer, PA-C

  • Physician Assistant
  • Santa Rosa, CA
  • NPI 1740966449
  Medicare reassignment

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1497329940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 DIVISADERO ST. PMB 759",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941172213",
            "telephone_number": "415-523-5235",
            "fax_number": "415-523-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVE STE 210",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054833",
            "telephone_number": "209-339-8921",
            "fax_number": "415-523-5235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "167 Lynch Creek Way",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949542343",
            "country_code": "US",
            "telephone_number": "707-324-3241",
            "fax_number": "707-324-3241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "490 Post St Ste 1701",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941021308",
            "country_code": "US",
            "telephone_number": "415-523-5235",
            "fax_number": "415-523-5235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BAY AREA ESTHETICS PLASTIC SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "POURTAHERI",
        "authorized_official_first_name": "NAVID",
        "authorized_official_title_or_position": "PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "415-523-5235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Area Esthetics Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bay Area Esthetics Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Baumann
• Benjamin Robert Baumgardner, DPT
• Bautista and Patel Dental
• Martin Bautista
• Stephanie Baxman
• Bay Area Foot Care Inc
• Bay Area Foot Care, Inc
• Bay Area Music Therapy LLC
• Bay Area Spine & Sport, Inc
• Nicole Bayard, DNP, FNP, APRN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.