Individual provider Active NPI

David Tay, M.D.

  • Specialist
  • Fremont, CA
National Provider Identifier
1962440263
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G63140 Issued in CA
Practice address
39233 Liberty St
Fremont, CA 94538-1501
Phone
(510) 795-8186
Fax
(510) 792-8186
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G63140 CA Primary

Addresses

Primary practice location

39233 Liberty St
Fremont, CA 94538-1501

Mailing address

39270 Paseo Padre Pkwy
Suite 518
Fremont, CA 94538-1616
Phone (510) 795-8186

Other identifiers 1

IdentifierTypeStateIssuer
00G631400MedicaidCA

Other names 1

  • David Tay Professional name

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
I20080417000711 CA Practitioner - NephrologyPractitioner - Internal Medicine 9830277789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

Hospital & facility affiliations

  • FMC Union City Dialysis Dialysis facility, Union City, CA, CCN 752505
  • Bio-Medical Applications of Fremont Dialysis facility, Fremont, CA, CCN 052722
  • Washington Hospital Hospital, Fremont, CA, CCN 050195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G63140CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Jan 30, 2008 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jan 30, 2008 Accepting new patients
Bio-Medical Applications of California, Inc. PastSince Jan 29, 2019 Accepting new patients

Locations

39233 Liberty St
Fremont, CA 94538
Phone (510) 795-8166

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

Interoperability endpoints

  • Direct secure messaging: dtaymdpamf15259@hisp.ehr.sutterhealth.org

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 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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1962440263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39270 PASEO PADRE PKWY",
            "address_2": "SUITE 518",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381616",
            "telephone_number": "510-795-8186",
            "fax_number": "510-792-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39233 LIBERTY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381501",
            "telephone_number": "510-795-8186",
            "fax_number": "510-792-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAY",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G63140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G631400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "TAY",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.