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Northbay Healthcare Group

Organization Active NPI General Acute Care Hospital · Fairfield, CA

NPI 1821147786 · NPPES record last updated Jun 9, 2025

Key facts

NPI
1821147786
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
110000093 (CA)
Legal business name
NORTHBAY HEALTHCARE GROUP
Practice address
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone
(707) 646-5000
NPI assigned
Jan 9, 2007
Organization subpart
Yes
Parent organization (as reported)
NORTHBAY HEALTHCARE GROUP

Authorized official

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

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.

Owners & managing parties with NPI records 1

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

Other NPIs on the same Medicare enrollment 3

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

Other NPIs with the same Medicare PAC ID 2

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

Practitioners 662

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 662

Affiliated clinicians 374

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

View all 374

Medicare Care Compare: Hospital

Listed as
Northbay Medical Center CCN 050367
Overall star rating
★★☆☆☆ 2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0598456Northbay Medical Center Laboratory
1200 B Gale Wilson Blvd, Fairfield, CA 94533		AccreditationAug 16, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA

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
Corporation · Non-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

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 Officer
Chief Financial Officer		 Jan 31, 2023
Theofanis Rallis
Individual 		W-2 Managing Employee
Avp, 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 Employee
Ad;		 Dec 1, 2024 1%
Mark Sievers
Individual 		Corporate Director Jun 26, 2003
Mark R Behl
Individual 		Corporate Officer
Chief Executive Officer		 Dec 3, 2023
Wayne Senalik
Individual 		Corporate Director Jun 26, 2003
Theresa Hite
Individual 		Corporate Director Jun 13, 2007

Medicare enrollment records

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

National Provider Directory

Part of
Vacavalley Hospital

Locations (25 of 45)

416 Napa Junction Rd
Ste 140
American Canyon, CA 94503

1808 W Lincoln Ave
Anaheim, CA 92801
Phone (530) 400-7190

2400 Balfour Rd
Ste 201
Brentwood, CA 94513
Phone (925) 308-8112

1325 Travis Blvd
Ste A
Fairfield, CA 94533

1261 Travis Blvd
Ste 150
Fairfield, CA 94533
Phone (707) 426-4696

4520 Business Center Dr
#200
Fairfield, CA 94534

2500 Hilborn Rd
Ste A
Fairfield, CA 94534

4520 Business Center Dr
Ste 400
Fairfield, CA 94534

1860 Pennsylvania Ave
Ste 320
Fairfield, CA 94533
Phone (707) 260-5719

1860 Pennsylvania Ave
Ste 180
Fairfield, CA 94533

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

4520 Business Center Dr
Fairfield, CA 94534

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

1860 Pennsylvania Ave
Ste 120
Fairfield, CA 94533
Phone (707) 426-4696

4520 Business Center Dr
Ste 180
Fairfield, CA 94534
Phone (707) 646-3555

1852 W Texas St Ste 216
Fairfield, CA 94533

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

2470 Hilborn Rd
Ste 200
Fairfield, CA 94534

4500 Business Center Dr
#200
Fairfield, CA 94534

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

1320 Travis Blvd
Fairfield, CA 94533

1860 Pennsylvania Ave
Ste 1100
Fairfield, CA 94533

2458 Hilborn Rd
Ste 101
Fairfield, CA 94534

2470 Hilborn Rd
Ste 110
Fairfield, CA 94534
Phone (707) 646-4699

411 Grand Ave
Oakland, CA 94610
Phone (510) 465-3668

Specialties & licenses

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

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

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

Other names

  • dba NorthBay Medical Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 9, 2025.

{
    "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": "MEDI-CAL INPATIENT",
            "identifier": "ZZR00367F",
            "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 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": "NPI NORTHBAY VACAVALLEY HOSPITAL",
            "identifier": "1255483202",
            "state": null
        }
    ],
    "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

All providers in Fairfield, CA · General Acute Care Hospital in California

Sources for this page

Verify at the official NPI Registry.