Michael Anthony Bardo, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA62011 Issued in CA

Practice address

1086 S Fairfax Ave
Los Angeles, CA 90019-4401

Phone

(424) 258-0124

NPI assigned

Apr 13, 2023

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 CA

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

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.

• Ghods Inc

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1790344869
  Medicare reassignment
• Physicians and Surgeons Home Care Inc

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1184105231
  Medicare reassignment

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1285320101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25745 BARTON RD STE 238",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543812",
            "telephone_number": "818-235-7838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 S FAIRFAX AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900194401",
            "telephone_number": "424-258-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA62011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Scott Bard, LPT
• Boo Young Jun Bardales, DNP, AGPCNP-BC, C
• Mark Antonio Bardalez
• Christian Bardan, MD
• James Migliaccio Bardes, M.D.
• Denise Bardovi, MA, MFT
• Richard Bardowell, M.D.
• Rozheen Mary Barekatein
• Maria E Barelli, MSW
• Brooke Barello

• Medical Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.