Individual provider Active NPI

Stephen Fils Bazilme, PA, SA-C

  • Medical Physician Assistant
  • Goodyear, AZ
National Provider Identifier
1467110890
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8614 Issued in AZ
Practice address
700 N Estrella Pkwy Ste 120
Goodyear, AZ 85338-9271
Phone
(561) 331-7471
NPI assigned
Dec 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 22-423 WI
Clinical Medical Laboratory 291U00000X 109977 IL
Medical Physician Assistant 363AM0700X TPPA485 FL
Medical Physician Assistant 363AM0700X 683-P.A. PR
Medical Physician Assistant 363AM0700X 8614 AZ Primary

Addresses

Primary practice location

700 N Estrella Pkwy Ste 120
Goodyear, AZ 85338-9271

Mailing address

12758 Wood Hollow Dr Apt 1721
Woodbridge, VA 22192-6545
Phone (561) 331-7471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8614AZMDPhysical Therapist
22-423WIMDSurgical Assistant
109977ILMDClinical Medical Laboratory
TPPA485FLMDMedical Physician Assistant
683-P.A.PRMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1467110890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12758 WOOD HOLLOW DR APT 1721",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926545",
            "telephone_number": "561-331-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N ESTRELLA PKWY STE 120",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389271",
            "telephone_number": "561-331-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZILME",
        "first_name": "STEPHEN FILS",
        "name_prefix": "Dr.",
        "credential": "PA, SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-02",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "22-423",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "109977",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "TPPA485",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "683-P.A.",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "8614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.