Dimitri Bazin, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

P04485 Issued in NY

Practice address

3418 Broadway Ofc 2
New York, NY 10031-7408

Phone

(212) 283-2099

NPI assigned

Dec 6, 2016

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• William F Ryan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1851328199
  Medicare reassignment NPD
• William F Ryan Community Health Center Inc

  dba Ryan Health Midtown Emotional Wellness Center

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1043079064
  NPD
• William F Ryan Community Health Center Inc

  dba Ryan Women & Children's Community Health Center

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1124347182
  NPD

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1174067425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 W 125TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100273424",
            "telephone_number": "212-470-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 BROADWAY OFC 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100317408",
            "telephone_number": "212-283-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZIN",
        "first_name": "DIMITRI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-06",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "P04485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl W. Bazil, M.D, PH.D.
• Flerida Bazil
• Sarah Hale Bazil, LMT
• Bertha Bazile
• Soraya Bazile, RN
• Elizabeth Torosian Bazinet, MS, CGC
• Anne Bazluke
• Vahid Bazojoo, M.D.
• Narek Gagik Bazyan, PA-C
• Stephanie C Bazylewicz, RPA-C

• Medical Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.