Sandra Paula Bazan-Olson, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

303932 Issued in AZ

Practice address

701 West Wetmore Rd. RM. 168
Amphitheater Public Schools
Tucson, AZ 85705-1547

Phone

(520) 696-5237

Fax

(520) 696-5067

NPI assigned

Sep 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Active Vital Care LLCGroup PAC ID 3870942428, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Active Vital Care LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1326825092
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1083864136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 WEST WETMORE RD. RM. 168",
            "address_2": "PIMACO AMPHITHEATERSCHOOLS DBA AMPHITHEATER PUB SCHOOLS",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857051547",
            "telephone_number": "520-696-5237",
            "fax_number": "520-696-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WEST WETMORE RD. RM. 168",
            "address_2": "AMPHITHEATER PUBLIC SCHOOLS",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857051547",
            "telephone_number": "520-696-5237",
            "fax_number": "520-696-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZAN-OLSON",
        "first_name": "SANDRA",
        "middle_name": "PAULA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "303932",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "RN128955",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Bayne, PA-C
• Joy Baynes
• Bayou Surgical Iup, LLC
• Taylor Morgan Bays, LMT
• Brian Bayze, M.D.
• Jennifer Bazan-Wigle, PT, DPT
• Emily Bazi, MD
• Erica Renee Bazua, FNP-C
• Gabriel Jacob Bazurto Jr., LISAC
• Charles Mark Bazzell, MD

• Primary Care Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.