Individual provider Active NPI

Thomas Sample Bailey Jr., MD

  • Obstetrics & Gynecology Physician
  • Mission Viejo, CA
National Provider Identifier
1598714818
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G22648 Issued in CA
Practice address
26800 Crown Valley Pkwy
Suite 525
Mission Viejo, CA 92691-8029
Phone
(949) 364-1040
Fax
(949) 365-7037
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G22648 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy
Suite 525
Mission Viejo, CA 92691-8029

Mailing address

26800 Crown Valley Pkwy
Suite 525
Mission Viejo, CA 92691-8029
Phone (949) 364-1040

Other identifiers 1

IdentifierTypeStateIssuer
G226480MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbailey1373921@oc.providencedirect.org

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
I20040427000261 CA Practitioner - Obstetrics/Gynecology 8022005693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Arizona College of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

395 W Avenida Vista Hermosa
San Clemente, CA 92672-7720
Phone (949) 304-2117

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G22648CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Nov 6, 2017 Accepting new patients
Providence Medical Foundation CurrentSince Nov 6, 2017 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Providence Medical Foundation Obstetrics & Gynecology Past Accepting new patients

Locations

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

26800 Crown Valley Pkwy
Ste 525
Mission Viejo, CA 92691
Phone (949) 364-1040

665 Camino de los Mares
Ste 303A
San Clemente, CA 92673
Phone (949) 364-1040

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1598714818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "address_2": "SUITE 525",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918029",
            "telephone_number": "949-364-1040",
            "fax_number": "949-365-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "address_2": "SUITE 525",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918029",
            "telephone_number": "949-364-1040",
            "fax_number": "949-365-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "THOMAS",
        "middle_name": "SAMPLE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G22648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G226480",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbailey1373921@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy",
            "address_2": "Suite 525",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926918029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.