Individual provider Active NPI

Anthony S. Maldonado, M.D.

  • Emergency Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1295821833
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A94678 Issued in CA
Practice address
400 Old River Rd
Bakersfield, CA 93311-9781
Phone
(661) 477-9283
Fax
(661) 326-8022
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 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 A94678 CA Primary

Addresses

Primary practice location

400 Old River Rd
Bakersfield, CA 93311-9781

Mailing address

PO Box 20577
Bakersfield, CA 93390-0577
Phone (661) 477-9283

Other identifiers 1

IdentifierTypeStateIssuer
00A946780OtherCAMEDI-CAL

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20070830000622 CA Practitioner - Emergency Medicine 9133212566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Geffen School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011

1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Baldwin Park Hospital, Baldwin Park, CA, CCN 050723

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94678CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 30, 2008 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 30, 2008 Accepting new patients

Locations

1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1295821833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20577",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933900577",
            "telephone_number": "661-477-9283",
            "fax_number": "661-326-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OLD RIVER RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119781",
            "telephone_number": "661-477-9283",
            "fax_number": "661-326-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "ANTHONY",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A94678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A946780",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.