Individual provider Active NPI

Andrew Bazakis, M.D.

  • Emergency Medicine Physician
  • Saginaw, MI
National Provider Identifier
1114914603
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301076118 Issued in MI
Practice address
900 Cooper
Saginaw, MI 48602
Phone
(989) 583-6521
Fax
(989) 583-4134
NPI assigned
Sep 30, 2005
Last updated
Mar 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301076118 MI Primary

Addresses

Primary practice location

900 Cooper
Saginaw, MI 48602

Mailing address

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-6521

Other identifiers 1

IdentifierTypeStateIssuer
4232273MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abazakismd1328@direct.covenanthealthcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NY2 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

Enrollment IDStateProvider typePAC IDDetails
I20050915000932 MI Practitioner - Emergency Medicine 9739112129 Reassigns benefits to 2 organizations
I20140207000067 NY Practitioner - Emergency Medicine 9739112129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

900 Cooper Ave
Suite 4100
Saginaw, MI 48602-5182
Phone (989) 583-7175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc CurrentSince Jun 30, 2000 Accepting new patients
Emergency Professionals of Michigan, P.C. Emergency Medicine CurrentSince Oct 1, 2013 Accepting new patients
Covenant Medical Center, Inc. Emergency Medicine Current Accepting new patients

Locations

7300 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

900 Cooper Ave
Ste 4100
Saginaw, MI 48602
Phone (989) 497-9395

Interoperability endpoints

  • Direct secure messaging: abazakismd1328@direct.covenanthealthcare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1114914603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-583-6521",
            "fax_number": "989-583-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COOPER",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48602",
            "telephone_number": "989-583-6521",
            "fax_number": "989-583-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZAKIS",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301076118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4232273",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abazakismd1328@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "900 Cooper",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.