Individual provider Active NPI

Nikolai Alexander Bildzukewicz, M.D.

  • Surgery Physician
  • Fullerton, CA
National Provider Identifier
1255547493
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A82509 Issued in CA
Practice address
1950 Sunny Crest Dr Ste 2500
Fullerton, CA 92835-3644
Phone
(714) 263-9383
NPI assigned
May 15, 2007
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A82509 CA Primary

Addresses

Primary practice location

1950 Sunny Crest Dr Ste 2500
Fullerton, CA 92835-3644

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-9062

Other practice location 1

2151 N Harbor Blvd Ste 3100
Fullerton, CA 92835-3825
Phone (714) 446-5830

Other practice location 2

1450 San Pablo St Ste 6200
Los Angeles, CA 90033-5331
Phone (323) 442-9062

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nikolai.bildzukewicz@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110811000495 CA Practitioner - General Surgery 6608045455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

15855 Pomona Rincon Rd
BLDG 4
Chino Hills, CA 91709-3162
Phone (909) 929-2511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux184
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82509CAMDSchool Social Worker
A82509CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Apr 18, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 16, 2012 Accepting new patients
Providence Medical Foundation CurrentSince Apr 18, 2022 Accepting new patients
Usc Care Medical Group, Inc Surgery CurrentSince Jul 16, 2012 Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Regents of the University of California Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

15855 Pomona Rincon Rd
Bldg 4
Chino Hills, CA 91709
Phone (909) 264-8666

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2500
Fullerton, CA 92835
Phone (714) 263-9383

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

2151 N Harbor Blvd
Ste 3100
Fullerton, CA 92835
Phone (530) 999-2533

1450 San Pablo St
Ste 6200
Los Angeles, CA 90033
Phone (323) 442-7920

1450 San Pablo St
Ste HC46200
Los Angeles, CA 90033

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Interoperability endpoints

  • Direct secure messaging: nbildzukewicz887597@oc.providencedirect.org

Organizations & group practices 12

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1255547493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 2500",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353644",
            "telephone_number": "714-263-9383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2151 N Harbor Blvd Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353825",
            "country_code": "US",
            "telephone_number": "714-446-5830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1450 San Pablo St Ste 6200",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335331",
            "country_code": "US",
            "telephone_number": "323-442-9062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BILDZUKEWICZ",
        "first_name": "NIKOLAI",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A82509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nikolai.bildzukewicz@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1450 San Pablo St",
            "address_2": "Suite 6200",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900334500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.