Individual provider Active NPI

Nolan Bayen, M.D.

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1639541014
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A138558 Issued in CA
Practice address
7601 Hospital Dr Ste 103
Sacramento, CA 95823-5408
Phone
(916) 681-1600
NPI assigned
Oct 26, 2015
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
Family Medicine Physician 207Q00000X A138558 CA Primary

Addresses

Primary practice location

7601 Hospital Dr Ste 103
Sacramento, CA 95823-5408

Mailing address

7601 Hospital Dr Ste 103
Sacramento, CA 95823-5408
Phone (916) 681-1600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nbayen1657477@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
I20170724003401 CA Practitioner - Family PracticePractitioner - Hospitalist 9436429495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Loma Linda University School of Medicine, 2014
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)

400 N McDowell Blvd
Petaluma, CA 94954-2339
Phone (707) 778-2631

Hospital & facility affiliations

  • Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136
  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A138558CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince Jul 2, 2018 Accepting new patients
Providence Medical Foundation CurrentSince Jul 2, 2018 Accepting new patients

Locations

2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

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

Interoperability endpoints

  • Direct secure messaging: nbayen1657477@oc.providencedirect.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.

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": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1639541014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 HOSPITAL DR STE 103",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235408",
            "telephone_number": "916-681-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 HOSPITAL DR STE 103",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235408",
            "telephone_number": "916-681-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYEN",
        "first_name": "NOLAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-26",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A138558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbayen1657477@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2700 Dolbeer St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955014736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.