Individual provider Active NPI

Mariz Jane Bacasmo Carizon, FNP

  • Family Nurse Practitioner
  • Rancho Mirage, CA
National Provider Identifier
1396524567
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027416 Issued in CA
Practice address
39000 Bob Hope Dr
Rancho Mirage, CA 92270-3202
Phone
(760) 346-0642
Fax
(760) 340-9152
NPI assigned
Sep 26, 2023
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95027416 CA Primary
Registered Nurse 163W00000X 839010 CA

Addresses

Primary practice location

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3202

Mailing address

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3202
Phone (760) 346-0642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250123000885 OR Practitioner - Nurse Practitioner 1557890324 Reassigns benefits to 1 organization
I20250630000021 CA Practitioner - Nurse Practitioner 1557890324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 340-3911

39950 Vista del Sol
Rancho Mirage, CA 92270-3206
Phone (760) 340-0053

44419 Town Ctr Way
Suite E
Palm Desert, CA 92260-2704
Phone (760) 469-9843

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icco LLC CurrentSince Apr 20, 2024 Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Jun 1, 2025 Accepting new patients
Icco, LLC CurrentSince Apr 20, 2024 Accepting new patients
Carbon Health Medical Group of Massachusetts PC Past Accepting new patients

Locations

3955 Bedford Canyon Rd
Unit 103
Corona, CA 92883
Phone (951) 293-4722

401 Grand Ave
#1112
Oakland, CA 94610
Phone (800) 756-4206

44419 Town Center Way
Ste E
Palm Desert, CA 92260
Phone (760) 469-9843

600 Jefferson St
Ste 600
Lafayette, LA 70501
Phone (337) 202-0720

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

Organizations & group practices 5

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 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": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1396524567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703202",
            "telephone_number": "760-346-0642",
            "fax_number": "760-340-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703202",
            "telephone_number": "760-346-0642",
            "fax_number": "760-340-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARIZON",
        "first_name": "MARIZ JANE",
        "middle_name": "BACASMO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027416",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "839010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.