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TOMOMI SAMANTHA HAYASHI MD
NPI 1962822114
Pediatrics in San Jose, CA

Active since April 25, 2014PECOS Enrolled
2505 SAMARITAN DR STE 607, SAN JOSE, CA 95124(408) 356-9900 Get Directions Write a Review

NPPES record last updated: November 23, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tomomi Samantha Hayashi Md NPPES

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

TOMOMI SAMANTHA HAYASHI MD (NPI 1962822114) is an individual pediatrics provider in San Jose, California, licensed in California (A141550) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Orange.

NPPES Registry Identity

NPI1962822114
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameTOMOMI SAMANTHA HAYASHICredential: MD
Location Address2505 SAMARITAN DR STE 607San Jose, CA 95124-4017
Mailing Address2505 Samaritan Dr Ste 607San Jose, CA 95124-4017 · (408) 356-9900
Phone(408) 356-9900
Sole ProprietorNo
Enumeration DateApril 25, 2014
Last NPPES UpdateNovember 23, 2022
NPPES CertifiedNovember 23, 2022
✔ NPI 1962822114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A141550
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2505 SAMARITAN DR STE 607, San Jose, CA 95124
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Secondary Practice Location 1

Location 1505 S Main St Ste 525Orange, CA 92868-4553 · Phone (714) 456-5631 · Fax (714) 285-0389

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tomomi Samantha Hayashi Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Tomomi Hayashi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lpch Medical Group Div Of Lucile
18 mi
Children
725 WELCH RD
Palo Alto, CA 94304
  • Reassigned Medicare billing, California enrollment
  • 3,617 clinicians in this Medicare group
NPI 1417907940 (650) 498-6762

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Tomomi Hayashi's NPI number?

The NPI number for Tomomi Hayashi is 1962822114. It was assigned to this individual provider in the NPPES registry on April 25, 2014.

Where is Tomomi Hayashi located?

Tomomi Hayashi practices at 2505 Samaritan Dr Ste 607, San Jose, CA 95124. The listed phone number is (408) 356-9900.

What is Tomomi Hayashi's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Tomomi Hayashi enrolled in Medicare?

Yes. Tomomi Hayashi is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tomomi Hayashi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tomomi Hayashi reassigns Medicare benefits to Lpch Medical Group Div Of Lucile (Palo Alto, CA). The 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 Tomomi Hayashi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tomomi Hayashi was last updated on November 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.