Active NPI
Lisa J Bailer, P.A.
- Physician Assistant
- Newport Beach, CA
National Provider Identifier
1659485886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17673
- Practice address
- 351 Hospital Rd
Suite 401
Newport Beach, CA 92663-3509 - Phone
- (949) 642-6787
- Fax
- (949) 642-4833
- NPI assigned
- Aug 17, 2006
- Last updated
- Mar 11, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17673 | CA | Primary |
Addresses
Primary practice location
351 Hospital Rd
Suite 401
Newport Beach, CA 92663-3509
Mailing address
351 Hospital Rd
Suite 401
Newport Beach, CA 92663-3509
Phone (949) 642-6787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WPA17673B | Other | CA | PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Previously, effective Oct 1, 2016 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17673 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Psychiatric Associates Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Dana Point, CA
- NPI 1962641811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1659485886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 HOSPITAL RD",
"address_2": "SUITE 401",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926633509",
"telephone_number": "949-642-6787",
"fax_number": "949-642-4833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 HOSPITAL RD",
"address_2": "SUITE 401",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926633509",
"telephone_number": "949-642-6787",
"fax_number": "949-642-4833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILER",
"first_name": "LISA",
"middle_name": "J",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "WPA17673B",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.