Stephen J Bazzano, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14599 Issued in KS

Practice address

111 E 7TH St
Galena, KS 66739-1229

Phone

(620) 783-1358

Fax

(620) 783-5055

NPI assigned

Aug 11, 2006

Last updated

Aug 16, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Hospital Columbus

  dba Mercy Maude Norton Hospital

  • Critical Access Hospital
  • Columbus, KS
  • NPI 1619203452
  Medicare reassignment NPD
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  Medicare reassignment
• Bazzano Clinic PA

  • Family Medicine Physician
  • Galena, KS
  • NPI 1558699017
  Authorized official Same address or phone

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1063423150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "address_2": "111 E 7TH ST",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "66739",
            "telephone_number": "620-783-1358",
            "fax_number": "620-783-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 7TH ST",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "667391229",
            "telephone_number": "620-783-1358",
            "fax_number": "620-783-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZANO",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "32305",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "14599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MCR",
            "identifier": "080075003",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098210A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240387613",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James P Bales, PT
• Jordan Ball, DPT
• Brenna Barr
• Theresa Rae Baughman, CRNA
• Bazzano Clinic PA
• David G Blancho, DPM
• Ashley Michelle Boles, DPT
• Rachel Bowser, PTA
• Kayla Marie Brattin, RN, BSN, CRNA
• Dottie Rene Bringle

• Family Medicine Physician in Galena, KS
• Providers in Galena, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.