Diane Grace Bejerano, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

NONE YET Issued in AZ

Practice address

523 Rose LN
Wickenburg, AZ 85390-1448

Phone

(928) 668-1833

Fax

(928) 684-7457

NPI assigned

Feb 16, 2017

Sex

Female

Sole proprietor

No

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.

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917

  AZ, Family Medicine

  Medicare reassignment NPD
• Kingman Healthcare, Inc

  • Urgent Care Clinic/Center
  • Kingman, AZ
  • NPI 1760703805
  NPD
• Kingman Healthcare, Inc

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 5, 2021.

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1376082941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15453 W SIERRA ST",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853797217",
            "telephone_number": "626-278-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 ROSE LN",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901448",
            "telephone_number": "928-668-1833",
            "fax_number": "928-684-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEJERANO",
        "first_name": "DIANE",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-16",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "NONE YET",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Atwood
• Michael Bacon, PT
• Stephanie Baker, CRNA
• Dennis A Barraco, DO
• Lea Bastin, LAAC
• Darrell Allan Benham
• Robert Botbyl
• Bradshaw Mountain Diagnostic Laboratory Inc
• Jeremy J. Bramwell, DO
• Breedlove Wound Care of Arizona LLC

• All providers in Wickenburg, AZ
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.