Individual provider Active NPI

Mildred O Bay, MD

  • Pediatrics Physician
  • Spokane, WA
National Provider Identifier
1679528178
Registry record updated Nov 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00045245 Issued in WA
Practice address
1111 E Westview CT Ste B
Spokane, WA 99218-1376
Phone
(509) 626-9430
Fax
(509) 227-7070
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00045245 WA
Pediatrics Physician 208000000X MD00045245 WA Primary

Addresses

Primary practice location

1111 E Westview CT Ste B
Spokane, WA 99218-1376

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (509) 474-3568

Other practice location 1

7554 15th Ave NW
Seattle, WA 98117
Phone (360) 457-8578

Other identifiers 1

IdentifierTypeStateIssuer
8434359MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbay280305@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20210521001028 WA Practitioner - Pediatric Medicine 6608275797 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00045245WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Jul 4, 2021 Accepting new patients
Providence Health & Services Washington CurrentSince Jul 4, 2021 Accepting new patients
Ballard Pediatric Clinic Inc PS Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

8925 N Indian Trail Rd
Spokane, WA 99208
Phone (509) 352-7543

1111 E Westview Ct
Ste B
Spokane, WA 99218
Phone (509) 244-3627

Interoperability endpoints

  • Direct secure messaging: mbay280305@wm.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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636156800000",
    "number": "1679528178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-474-3568",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E WESTVIEW CT STE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181376",
            "telephone_number": "509-626-9430",
            "fax_number": "509-227-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7554 15th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98117",
            "country_code": "US",
            "telephone_number": "360-457-8578",
            "fax_number": "360-457-4841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAY",
        "first_name": "MILDRED",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00045245",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00045245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8434359",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbay280305@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1111 E Westview Ct Ste B",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992181376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.