Jose L Bazan, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95014164 Issued in CA

Practice address

1441 Florida Ave
Modesto, CA 95350-4404

Phone

(209) 578-1211

NPI assigned

Mar 10, 2020

Last updated

Mar 10, 2020By the provider in NPPES

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

Nurse Practitioner

Practice roles

Locations

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.

• Escalon Physical Medicine, Inc

  dba Modesto Physical Medicine

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1821417866
  Medicare reassignment NPD
• Hospitalists of Modesto Medical Group Inc

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1821190711
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Richmond, CA
  • NPI 1235226531
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Hospitalists of Modesto Medical Group

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1659712586
  NPD (past)

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1437784469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5418 FLINTRIDGE CT",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953679431",
            "telephone_number": "209-450-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-578-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZAN",
        "first_name": "JOSE",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bautistasatos
• Surekha Bavirti, MD
• Bay Area Foot Care, Inc (Bay Area Foot Care)
• Scott L Bayless, PH.D.
• Baz Allergy, Asthma & Sinus Center, Inc.
• Be Food Wise
• Donna Beach
• Christopher Beaken
• Chloe Pandora Beall-Vieyra
• Sahara Deseray Bean

• Family Nurse Practitioner in Modesto, CA
• Providers in Modesto, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.