Individual provider Active NPI

Randy E Bain, PA-C, MPHC

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1841774486
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55785 Issued in CA
Practice address
2670 S White Rd Ste 200
San Jose, CA 95148-2073
Phone
(408) 729-4290
NPI assigned
Sep 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA55785 CA Primary

Addresses

Primary practice location

2670 S White Rd Ste 200
San Jose, CA 95148-2073

Mailing address

2201 Shoreline Dr Unit 1565
Alameda, CA 94501-7339
Phone (480) 332-7771

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190509001836 CA Practitioner - Physician Assistant 5294078499 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA55785CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Feb 1, 2019 Accepting new patients
University of California San Francisco CurrentSince Feb 1, 2019 Accepting new patients
UCSF Medical Group Business Services CurrentSince Feb 1, 2019 Accepting new patients
University of California San Francisco CurrentSince Feb 1, 2019 Accepting new patients
UCSF Medical Group Business Services CurrentSince Feb 1, 2019 Accepting new patients

Locations

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1841774486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 SHORELINE DR UNIT 1565",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945017339",
            "telephone_number": "480-332-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 S WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482073",
            "telephone_number": "408-729-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIN",
        "first_name": "RANDY",
        "middle_name": "E",
        "credential": "PA-C, MPHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.