Individual provider Active NPI

Paul J. Bayard, MD

  • Family Medicine Physician
  • Oakland, CA
National Provider Identifier
1922101237
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G74328 Issued in CA
Practice address
3451 E 12TH St
2ND Floor
Oakland, CA 94601-3463
Phone
(510) 535-3500
Fax
(510) 535-4187
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G74328 CA Primary

Addresses

Primary practice location

3451 E 12TH St
2ND Floor
Oakland, CA 94601-3463

Mailing address

PO Box 22210
Oakland, CA 94623-2210
Phone (510) 535-4000

Other identifiers 4

IdentifierTypeStateIssuer
ZZZ79046ZOtherCAMEDICARE PROVIDER NUMBER
051822OtherCAFQHC MEDICARE PROVIDER #
551975OtherCAFQHC MEDICARE PROVIDER #
ZZZ29799ZOtherCAMEDICARE PROVIDER NUMBER

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
I20040804000326 CA Practitioner - Family Practice 9931170891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

3451 E 12TH St
Oakland, CA 94601-3463
Phone (510) 535-3500

Hospital & facility affiliations

  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043

National Provider Directory

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

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc CurrentSince Feb 11, 2010 Accepting new patients
La Clinica de la Raza Inc CurrentSince Feb 11, 2010 Accepting new patients

Locations

3451 E 12th St
Fl 2
Oakland, CA 94601
Phone (510) 535-3319

1515 Fruitvale Ave
Oakland, CA 94601
Phone (510) 535-6300

1030 International Blvd
Oakland, CA 94606
Phone (510) 238-5400

3451 E 12th St
Oakland, CA 94601
Phone (510) 535-3319

2021 Main St
Oakley, CA 94561
Phone (925) 776-8200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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 1

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1922101237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946232210",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 E 12TH ST",
            "address_2": "2ND FLOOR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013463",
            "telephone_number": "510-535-3500",
            "fax_number": "510-535-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYARD",
        "first_name": "PAUL",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G74328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "ZZZ79046Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC MEDICARE PROVIDER #",
            "identifier": "051822",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC MEDICARE PROVIDER #",
            "identifier": "551975",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "ZZZ29799Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.