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JAE-O BAE M.D.
NPI 1710196019
Surgery - Pediatric Surgery in Phoenix, AZ

Active since May 22, 2007PECOS EnrolledAccepts Medicare Assignment
1919 E THOMAS RD, PHOENIX, AZ 85016(602) 933-0016(602) 933-4309 Get Directions Write a Review

NPPES record last updated: January 23, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jae-o Bae M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAE-O BAE M.D. (NPI 1710196019) is an individual pediatric surgery provider in Phoenix, Arizona, licensed in Arizona (42085) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in Phoenix, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1710196019
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameJAE-O BAECredential: M.D.
Location Address1919 E THOMAS RDPhoenix, AZ 85016-7710
Mailing Address3200 E Camelback Rd Ste 250Phoenix, AZ 85018-2327 · (602) 933-1813 · Fax (602) 933-1820
Phone(602) 933-0016
Fax(602) 933-4309
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateMay 22, 2007
Last NPPES UpdateJanuary 23, 2018
✔ NPI 1710196019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License✔ Licensed in AZ · 42085
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
1919 E THOMAS RD, Phoenix, AZ 85016
Open in Google Maps ↗

Secondary Practice Location 1

Location 11920 E Cambridge Ave, Suite #201Phoenix, AZ 85006-1459 · Phone (602) 254-5561 ext. 147 · Fax (602) 254-2185

Other Identifiers 1

Medicaid430210AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jae-o Bae M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274686605
PECOS Enrollment IDI20090803000707
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jae-o Bae reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Phoenix Children's Hospital
Same address
Pediatrics
1919 E THOMAS RD
Phoenix, AZ 85016
  • Reassigned Medicare billing, Arizona enrollment
  • 1,416 clinicians in this Medicare group
NPI 1922112044 (602) 933-1000
District Medical Group, Inc
1.6 mi
Surgery
2525 E ROOSEVELT ST, MED CLINIC - INFECTIOUS DISEASE
Phoenix, AZ 85008
  • Reassigned Medicare billing, Arizona enrollment
  • 1,490 clinicians in this Medicare group
NPI 1174856280 (602) 344-1095

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TIMUR RAGHIB M.D.
Hospitalist
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-0777
MRS. MARIA T ESCOBAR CSP, RD
Dietitian, Registered
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (480) 440-2787
DR. AHMAR HUSAIN MD
Anesthesiology (Pediatric Anesthesiology)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-4660
MRS. SOLEE R COWLEY LCSW
Social Worker (Clinical)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-0414
MR. SEAN PATRICK BRADY DO
Anesthesiology (Pediatric Anesthesiology)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-4660
PRIYA PRASHER M.D.
Pediatrics
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-1900
DR. AMIT RAJARAM D.O.
Pediatrics
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-0198
LAURA GARDNER HAMANT
Pediatrics (Pediatric Gastroenterology)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jae-o Bae's NPI number?

The NPI number for Jae-o Bae is 1710196019. It was assigned to this individual provider in the NPPES registry on May 22, 2007.

Where is Jae-o Bae located?

Jae-o Bae practices at 1919 E Thomas Rd, Phoenix, AZ 85016. The listed phone number is (602) 933-0016.

What is Jae-o Bae's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Jae-o Bae enrolled in Medicare?

Yes. Jae-o Bae is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jae-o Bae's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jae-o Bae reassigns Medicare benefits to 2 organizations: Phoenix Children's Hospital (Phoenix, AZ) and District Medical Group, Inc (Phoenix, AZ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jae-o Bae's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jae-o Bae accept?

Health plans from Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and Imperial Insurance Companies, Inc. list Jae-o Bae as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jae-o Bae was last updated on January 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.