Active NPI
Fay Bagarinao
- Family Medicine Physician
- Bethalto, IL
National Provider Identifier
1790898575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036107093
- Practice address
- 155 E Bethalto Dr
Bethalto, IL 62010-1801 - Phone
- (618) 377-8961
- NPI assigned
- Aug 16, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036107093 | IL | Primary |
Addresses
Primary practice location
155 E Bethalto Dr
Bethalto, IL 62010-1801
Mailing address
155 E Bethalto Dr
Bethalto, IL 62010-1801
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0361070933 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000
91 -5431 Kapolei Pkwy
Suite 1706
Kapolei, HI 96707-5000
Phone (808) 426-9300
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.72 of 100
- Quality
- 67.55
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036107093 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Straub Clinic & Hospital | Current | Accepting new patients | |
| Straub Clinic & Hospital | Current | Accepting new patients | |
| Fairview Heights Medical Group SC | Past | Accepting new patients | |
| Straub Clinic & Hospital | Past | Accepting new patients |
Locations
1001 Queen St
Ste 102
Honolulu, HI 96814
Phone (808) 462-5200
2255 Kalakaua Ave
#1
Honolulu, HI 96815
Phone (808) 971-6000
888 S King St
Honolulu, HI 96813
Phone (808) 522-4000
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Straub Benioff Medical Center
- Multi-Specialty Clinic/Center
- Honolulu, HI
- NPI 1457306508
-
dba Hawaii Pacific Health Specialty Pharmacy
- Community/Retail Pharmacy
- Honolulu, HI
- NPI 1295443216
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1679503668
-
- Durable Medical Equipment & Medical Supplies
- Honolulu, HI
- NPI 1851443733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790898575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 E BETHALTO DR",
"city": "BETHALTO",
"state": "IL",
"postal_code": "620101801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 E BETHALTO DR",
"city": "BETHALTO",
"state": "IL",
"postal_code": "620101801",
"telephone_number": "618-377-8961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGARINAO",
"first_name": "FAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036107093",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0361070933",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethalto, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- 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.