Active NPI
Northbay Healthcare Group
- Community Based Hospice Care Agency
- Fairfield, CA
National Provider Identifier
1720070071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- NORTHBAY HEALTHCARE GROUP
- Practice address
- 1101 B.Gale Wilson Blvd
Suite 101a
Fairfield, CA 94533 - Phone
- (707) 646-3595
- Fax
- (707) 646-3577
- NPI assigned
- Aug 22, 2005
- Organization subpart
- Yes
- Parent organization
- NORTHBAY HEALTHCARE GROUP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John David Ryland
- Title
- Hospice Manager
- Phone
- (707) 646-4095
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
1101 B.Gale Wilson Blvd
Suite 101a
Fairfield, CA 94533
Mailing address
4500 Business Center Drive
Fairfield, CA 94534-6888
Phone (707) 646-3595
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 550009228 | Other | CA | DEPARTMENT OF PUBLIC HEALTH LICENSE |
| HPC01651F | Medicaid | CA |
Other names 1
- NorthBay Hospice & Bereavement
Care Compare: Hospice
Medicare Care Compare- Listed as
- Northbay Hospice & Bereavement
- Ownership
- Other
- Certified
- May 10, 1995
- Medicare certification status
- Active
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address. The facility is not in the current Medicare enrollment files, which can mean its Medicare enrollment has ended (or, for VA and military hospitals, that it does not enroll).
National Provider Directory
National Provider Directory- Part of
- Vacavalley Hospital
Locations
1101 B Gale Wilson Blvd
Ste 101A
Fairfield, CA 94533
Phone (707) 646-3595
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Multi-Specialty Clinic/Center
- Oakland, CA
- NPI 1225363757
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1746057600000",
"number": "1720070071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 BUSINESS CENTER DRIVE",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945346888",
"telephone_number": "707-646-3595",
"fax_number": "707-646-3577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 B.GALE WILSON BLVD",
"address_2": "SUITE 101A",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "94533",
"telephone_number": "707-646-3595",
"fax_number": "707-646-3577"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHBAY HEALTHCARE GROUP",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "NORTHBAY HEALTHCARE GROUP",
"enumeration_date": "2005-08-22",
"last_updated": "2025-05-01",
"certification_date": "2025-05-01",
"status": "A",
"authorized_official_last_name": "RYLAND",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "HOSPICE MANAGER",
"authorized_official_telephone_number": "707-646-4095"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF PUBLIC HEALTH LICENSE",
"identifier": "550009228",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HPC01651F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "NorthBay Hospice & Bereavement",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "NorthBay Hospice & Bereavement",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fairfield, CA
- Northbay Family Compounding Pharmacy LLC
- Northbay Health Advantage
- Northbay Health Foundation
- Northbay Health Medical Foundation
- Northbay Healthcare Group
- Northbay Healthcare Group
- Northbay Healthcare Group
- Northbay Healthcare Group
- Northbay Medical Center Pharmacy
- Northern California Injury Centers Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.