Individual provider Active NPI

Tomomi Samantha Hayashi, MD

  • Pediatrics Physician
  • San Jose, CA
National Provider Identifier
1962822114
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A141550 Issued in CA
Practice address
2505 Samaritan Dr Ste 607
San Jose, CA 95124-4017
Phone
(408) 356-9900
NPI assigned
Apr 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X A141550 CA Primary

Addresses

Primary practice location

2505 Samaritan Dr Ste 607
San Jose, CA 95124-4017

Mailing address

2505 Samaritan Dr Ste 607
San Jose, CA 95124-4017
Phone (408) 356-9900

Other practice location 1

505 S Main St Ste 525
Orange, CA 92868-4553
Phone (714) 456-5631

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
I20220727004163 CA Practitioner - Pediatric Medicine 7416247804 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141550CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince May 27, 2022 Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
University of California Irvine Past Accepting new patients
Good Samaritan Hospital Ca LTD PTP Past Accepting new patients
El Camino Hospital Past Accepting new patients
El Camino Hospital Past Accepting new patients
Silicon Valley Pediatricians, Inc Pediatrics PastSince Nov 27, 2022 Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Locations

14651 S Bascom Ave
Ste 200
Los Gatos, CA 95032
Phone (408) 356-2154

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

2505 Samaritan Dr
Ste 607
San Jose, CA 95124
Phone (408) 356-9900

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: thayashi45245@icare.elcaminohospital.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1962822114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 SAMARITAN DR STE 607",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244017",
            "telephone_number": "408-356-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 SAMARITAN DR STE 607",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244017",
            "telephone_number": "408-356-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Main St Ste 525",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684553",
            "country_code": "US",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYASHI",
        "first_name": "TOMOMI",
        "middle_name": "SAMANTHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A141550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.