NPIMap

Organization Active NPI

Northbay Healthcare Group

Doing business as dba NorthBay Medical Center

  • General Acute Care Hospital
  • Fairfield, CA
National Provider Identifier
1821147786
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
110000093 Issued in CA
Legal business name
NORTHBAY HEALTHCARE GROUP
Doing business as
dba NorthBay Medical Center
Practice address
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone
(707) 646-5000
NPI assigned
Jan 9, 2007
Last updated
Jun 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHBAY HEALTHCARE GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Jaye Lynn Bonham
Title
Avp, Managed Care
Phone
(707) 646-3289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 110000093 CA Primary

Addresses

Primary practice location

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552

Mailing address

4500 Business Center Dr
Fairfield, CA 94534-6888

Other practice location 1

4500 Business Center Dr
Patient Financial Services
Fairfield, CA 94534-6888
Phone (707) 646-3401

Other practice location 2

1000 Nut Tree Rd
Vacaville, CA 95687-4100
Phone (707) 624-7000

Other identifiers 5

IdentifierTypeStateIssuer
1255483202OtherNPI NORTHBAY VACAVALLEY HOSPITAL
HSP40367FOtherCAMEDI-CAL OUTPATIENT
110000093OtherCADHS LICENSE
GR0093200OtherCAMEDI-CAL PHYSICIAN GROUP
ZZR00367FOtherCAMEDI-CAL INPATIENT

Other names 1

  • dba NorthBay Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000409 CA Part B Supplier - Clinic/Group Practice 0042122244 Receives reassigned benefits from 556 practitioners
3 other NPIs on this enrollment
Practice locations: Vacaville, CA; Winters, CA; Rio Vista, CA; Napa, CA; Fairfield, CA; American Canyon, CA; Dixon, CA
O20101018000818 CA Part A Provider - Hospital 0042122244 Practice locations: Fairfield, CA; Vacaville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821147786. Details of each certification follow.

Hospital certification: CCN 050367

Legal name
NORTHBAY PHYSICIANS SURGERY CENTER, LLC
Doing business as
NORTHBAY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 31, 1967
Last certification
Sep 15, 2017
Beds
123
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 29, 1954 in CA
Enrollment address
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Northbay Medical CenterCCN 050367 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0598456Northbay Medical Center Laboratory1200 B Gale Wilson Blvd, Fairfield, CA 94533AccreditationAug 16, 2027

National Provider Directory

National Provider Directory
Part of
McCombs and Wilson MDS

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations (25 of 52)

416 Napa Junction Rd
American Canyon, CA 94503

2701 Chester Ave
Ste 101
Bakersfield, CA 93301
Phone (661) 716-9400

2850 Telegraph Ave
Ste 120
Berkeley, CA 94705
Phone (510) 204-8140

3100 San Pablo Ave
Ste 400
Berkeley, CA 94702
Phone (510) 985-5200

1200 Central Blvd
Ste C
Brentwood, CA 94513
Phone (800) 573-8462

1101 B Gale Wilson Blvd
Ste 101
Fairfield, CA 94533
Phone (707) 646-4644

1101 B Gale Wilson Blvd
Ste 101A
Fairfield, CA 94533
Phone (707) 646-3595

1101 B Gale Wilson Blvd
Ste 101B
Fairfield, CA 94533

1101 B Gale Wilson Blvd
Ste 203
Fairfield, CA 94533
Phone (707) 429-7701

1320 Travis Blvd
Fairfield, CA 94533

1325 Travis Blvd
Ste A
Fairfield, CA 94533

1852 W Texas St Ste 216
Fairfield, CA 94533

1860 Pennsylvania Ave
Ste 110
Fairfield, CA 94533
Phone (707) 254-9693

1860 Pennsylvania Ave
Ste 1100
Fairfield, CA 94533

1860 Pennsylvania Ave
Ste 180
Fairfield, CA 94533

1860 Pennsylvania Ave
Ste 210
Fairfield, CA 94533
Phone (707) 646-4191

2458 Hilborn Rd
Ste 101
Fairfield, CA 94534

2470 Hilborn Rd
Ste 200
Fairfield, CA 94534

2470 Hilborn Rd
Ste 240
Fairfield, CA 94534
Phone (707) 646-3575

2500 Hilborn Rd
Fairfield, CA 94534
Phone (707) 646-3445

2500 Hilborn Rd
Ste A
Fairfield, CA 94534

3250 Rancho Solano Pkwy
Fairfield, CA 94534
Phone (707) 646-5470

4500 Business Center Dr
Fairfield, CA 94534
Phone (707) 646-4777

4500 Business Center Dr
#200
Fairfield, CA 94534

4520 Business Center Dr
Fairfield, CA 94534
Phone (707) 646-3500

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Denise Suihkonen Individual Corporate Director Jun 13, 2007
Joseph D Angina Individual Corporate OfficerChief Financial Officer Jan 31, 2023
Theofanis Rallis Individual W-2 Managing EmployeeAvp, Finance Nov 30, 2019
Donald R Doyle Individual Corporate Director Feb 3, 2006
Archie Humphrey Individual Corporate Director May 28, 2002
Brian Richerson Individual W-2 Managing EmployeeAd; Dec 1, 2024 1%
Mark Sievers Individual Corporate Director Jun 26, 2003
Mark R Behl Individual Corporate OfficerChief Executive Officer Dec 3, 2023
Wayne Senalik Individual Corporate Director Jun 26, 2003
Theresa Hite Individual Corporate Director Jun 13, 2007

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

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.

Practitioners & affiliated clinicians

Practitioners 661

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 661

Affiliated clinicians 374

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 374

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1821147786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 BUSINESS CENTER DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945346888",
            "fax_number": "707-646-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 B GALE WILSON BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333552",
            "telephone_number": "707-646-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Business Center Dr",
            "address_2": "Patient Financial Services",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945346888",
            "country_code": "US",
            "telephone_number": "707-646-3401",
            "fax_number": "707-646-4803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Nut Tree Rd",
            "address_purpose": "LOCATION",
            "city": "Vacaville",
            "state": "CA",
            "postal_code": "956874100",
            "country_code": "US",
            "telephone_number": "707-624-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHBAY HEALTHCARE GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHBAY HEALTHCARE GROUP",
        "enumeration_date": "2007-01-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "BONHAM",
        "authorized_official_first_name": "JAYE LYNN",
        "authorized_official_title_or_position": "AVP, MANAGED CARE",
        "authorized_official_telephone_number": "707-646-3289"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "110000093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NORTHBAY VACAVALLEY HOSPITAL",
            "identifier": "1255483202",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL OUTPATIENT",
            "identifier": "HSP40367F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS LICENSE",
            "identifier": "110000093",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PHYSICIAN GROUP",
            "identifier": "GR0093200",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL INPATIENT",
            "identifier": "ZZR00367F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba NorthBay Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "dba NorthBay Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.