NPIMap

Organization Active NPI

Ana Cardenas Dermatology, a Professional Corporation

  • MOHS-Micrographic Surgery Physician
  • Bakersfield, CA
National Provider Identifier
1114033842
Registry record updated Jul 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
G86302 Issued in CA
Legal business name
ANA CARDENAS DERMATOLOGY, A PROFESSIONAL CORPORATION
Practice address
3400 Calloway Dr
Suite 200
Bakersfield, CA 93312-2513
Phone
(661) 410-7546
Fax
(661) 410-7547
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2015

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

Authorized official

Name
Dr. Ana Amparo Cardenas, M.D.NPI 1841292026
Title
Owner
Phone
(661) 410-7546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X G86302 CA Primary

Addresses

Primary practice location

3400 Calloway Dr
Suite 200
Bakersfield, CA 93312-2513

Mailing address

3400 Calloway Dr
Suite 200
Bakersfield, CA 93312-2513
Phone (661) 410-7546

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ02042ZOtherCAPTAN

Other names 1

  • Advanced Cosmetic Dermatology, A Professional Corporation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050713000826 CA Part B Supplier - Clinic/Group Practice 6507892247 Receives reassigned benefits from 8 practitioners
Practice locations: Bakersfield, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1046193Advanced Cosmetic Dermatology, PC3400 Calloway Dr, Ste 200, Bakersfield, CA 93312ComplianceJul 31, 2026

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436140800000",
    "number": "1114033842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CALLOWAY DR",
            "address_2": "SUITE 200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122513",
            "telephone_number": "661-410-7546",
            "fax_number": "661-410-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CALLOWAY DR",
            "address_2": "SUITE 200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122513",
            "telephone_number": "661-410-7546",
            "fax_number": "661-410-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANA CARDENAS DERMATOLOGY, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2015-07-06",
        "status": "A",
        "authorized_official_last_name": "CARDENAS",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "AMPARO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-410-7546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "G86302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "ZZZ02042Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Cosmetic Dermatology, A Professional Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.