Individual provider Active NPI

Steven Bazan

  • Certified Registered Nurse Anesthetist
  • San Leandro, CA
National Provider Identifier
1336690387
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000435 Issued in CA
Practice address
2500 Merced St
San Leandro, CA 94577-4201
Phone
(510) 454-2070
NPI assigned
Oct 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 95000435 CA Primary

Addresses

Primary practice location

2500 Merced St
San Leandro, CA 94577-4201

Mailing address

42561 Hamilton Way
Fremont, CA 94538-5534

Other practice location 1

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateway Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210716000112 HI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052691565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan Inc 107 clinicians

Practice addresses (Care Compare)

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-8800

Hospital & facility affiliations

  • Kaiser Foundation Hospital Hospital, Honolulu, HI, CCN 120011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95000435CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan Inc Current Accepting new patients
Kaiser Foundation Health Plan Inc CurrentSince Jul 11, 2021 Accepting new patients
Kaiser Foundation Health Plan, Inc CurrentSince Jul 11, 2021 Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

599 Farrington Hwy
Kapolei, HI 96707
Phone (808) 432-3600

Organizations & group practices 9

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": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1336690387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42561 HAMILTON WAY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MERCED ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-2070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3288 Moanalua Rd",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968191469",
            "country_code": "US",
            "telephone_number": "808-432-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAZAN",
        "first_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-14",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateway",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3288 Moanalua Rd",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968191469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.