Bay Valley Medical Group, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BAY VALLEY MEDICAL GROUP, INC.

Practice address

20126 Stanton Ave
Ste 201
Castro Valley, CA 94546-5271

Phone

(510) 581-2559

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Matthew Burdusis

Title

Manager of Information Systems

Phone

(510) 266-5401

Specialties & licenses 4

Addresses

Other identifiers 3

Practitioners 1

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

• Michael Richard Forrest, MD

  • Radiation Oncology Physician
  • Dublin, CA
  • NPI 1700859352
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1497760870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27212 CALAROGA AVE",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945454339",
            "telephone_number": "510-785-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20126 STANTON AVE",
            "address_2": "STE 201",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465271",
            "telephone_number": "510-581-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY VALLEY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "BURDUSIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MANAGER OF INFORMATION SYSTEMS",
        "authorized_official_telephone_number": "510-266-5401"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR0024011",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D1079934",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0695762",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sophie Baylon, RD
• Baywood Court
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• Heather Beck

• Pediatrics Physician in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.