Individual provider Active NPI

Bao Thai Bui, M.D.

  • Cardiovascular Disease Physician
  • Fountain Valley, CA
National Provider Identifier
1801099593
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A125690 Issued in CA
Practice address
11100 Warner Ave
Suite 162
Fountain Valley, CA 92708-7506
Phone
(714) 432-1212
Fax
(714) 432-1215
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A125690 CA Primary

Addresses

Primary practice location

11100 Warner Ave
Suite 162
Fountain Valley, CA 92708-7506

Mailing address

11100 Warner Ave
Suite 162
Fountain Valley, CA 92708-7506
Phone (714) 432-1212

Other identifiers 1

IdentifierTypeStateIssuer
A125690OtherCACA STATE LICENSE

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
I20141210000879 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1355590324 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Pennsylvania State University College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11100 Warner Ave
Suite 162
Fountain Valley, CA 92708-7510
Phone (714) 432-1212

12 Hawkeye
Irvine, CA 92602-0851

17305 Von Karman Ave
Suite 107
Irvine, CA 92614-0903
Phone (949) 478-2230

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A125690CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Imaging, PC Cardiovascular Disease CurrentSince Jul 26, 2021 Accepting new patients
Inpatient Specialists PA Past Accepting new patients

Locations

6412 Laurel Ave
Mountain Mesa, CA 93240
Phone (760) 379-2681

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 3

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1801099593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 162",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-432-1212",
            "fax_number": "714-432-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 162",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-432-1212",
            "fax_number": "714-432-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI",
        "first_name": "BAO",
        "middle_name": "THAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A125690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LICENSE",
            "identifier": "A125690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.