THOMAS ANDREW BAILEY MD
NPI 1801807607
Internal Medicine in Youngstown, OH
NPI Status: Active since August 10, 2006
Contact Information
25 N CANFIELD NILES RD STE 160
YOUNGSTOWN, OH
ZIP 44515
Phone: (330) 953-3250
Fax: (330) 918-1713
- Individual
- Male
- Internal Medicine
- Opted-Out Medicare
- Medicare Quality Reporting
About THOMAS BAILEY
This page provides the complete NPI Profile along with additional information for Thomas Bailey, an internist established in Youngstown, Ohio with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1801807607 assigned on August 2006. The practitioner's primary taxonomy code is 207R00000X with license number 35080265B (OH). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1801807607
- Provider Name
- THOMAS ANDREW BAILEY MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 25 N CANFIELD NILES RD STE 160 YOUNGSTOWN, OH 44515
- Location Phone
- (330) 953-3250
- Location Fax
- (330) 918-1713
- Mailing Address
- 25 N CANFIELD NILES RD STE 160 YOUNGSTOWN, OH 44515
- Mailing Phone
- (330) 953-3250
- Mailing Fax
- (330) 918-1713
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-10-2006
- Last Update Date
- 01-04-2024
- Code Navigator
An internist like Thomas Bailey is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Thomas Bailey opted out of Medicare effective on 01-01-2024 until 01-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 35080265B
- License State
- OH
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| P006749 | OTHER (01) | OH | GATEWAY |
| 000000160585 | OTHER (01) | OH | UNISON |
| 000000329418 | OTHER (01) | OH | ANTHEM |
| 2313446 | MEDICAID (05) | OH | |
| 770623234027 | OTHER (01) | OH | CARESOURCE |
| P00123854 | OTHER (01) | OH | RR MEDICARE |
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-01-2024
Opt-Out End Date: 01-01-2026
Eligible to Order and Refer? No
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
Reviews for THOMAS ANDREW BAILEY MD
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1801807607, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1801807607, enumerated as an "individual" on August 10, 2006.
The provider is located at 25 N CANFIELD NILES RD STE 160 YOUNGSTOWN, OH 44515 and the phone number is (330) 953-3250.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: Medicare, Medicaid, Anthem Blue Cross, CareSource. Please consult your insurance carrier or call the provider to verify.
