Dmitriy Vladimirovich Bazaron, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95030783 Issued in CA

Practice address

3234 Marysville Blvd
Sacramento, CA 95815-1411

Phone

(916) 454-2345

NPI assigned

Jan 22, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doctors on Duty Medical Group, IncGroup PAC ID 2466366703, 64 clinicians

Elica Health CentersGroup PAC ID 4385706845, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

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.

• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1548425853
  Medicare reassignment Care Compare group NPD
• Doctors on Duty Medical Group, Inc

  • Urgent Care Clinic/Center
  • Salinas, CA
  • NPI 1568465466
  Medicare reassignment Care Compare group
• Ipc Hospitalists of New Mexico, Inc

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1578839163
  Medicare reassignment NPD
• New Mexico Center for Pain and Wellness, LLC

  • Pain Medicine Physician
  • Albuquerque, NM
  • NPI 1033803143
  Medicare reassignment NPD
• New Mexico Urgent Care Walk-in Clinic Juan Tabo LLC

  • Urgent Care Clinic/Center
  • Albuquerque, NM
  • NPI 1508510199
  Medicare reassignment NPD
• New Mexico Urgent Care Walk-in Clinic LLC

  • Urgent Care Clinic/Center
  • Albuquerque, NM
  • NPI 1700473824
  Medicare reassignment NPD
• Post Acute Rehabilitation Physicians LLC

  • Physical Medicine & Rehabilitation Physician
  • Lehi, UT
  • NPI 1023781028

  NM

  Medicare reassignment NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1760013494
  NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1760293351
  NPD
• Colorado Center for Pain and Wellness, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Colorado Springs, CO
  • NPI 1033918131

  Nurse Practitioner

  NPD
• Seaside Doctors on Duty

  • Non-Pharmacy Dispensing Site
  • Seaside, CA
  • NPI 1023450855
  NPD (past)

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1043728249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3234 MARYSVILLE BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958151411",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZARON",
        "first_name": "DMITRIY",
        "middle_name": "VLADIMIROVICH",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-22",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95030783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason C Baynes, LMFT
• Derek John Bays, MD
• Evamae Bayudan
• Bayview Neighborhood Heroes
• Irene Bazan
• Renya Bazikian, BA
• Samuel Bazuaye
• BBC Senior Services & Consulting, L.L.C.
• BC Cab Inc.
• BC Collective of Ca PC

• Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.