Michael Kazak MD Inc

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

MICHAEL KAZAK MD INC

Practice address

1040 W Main St
Santa Maria, CA 93458-4238

Phone

(805) 922-8269

Fax

(805) 349-9509

NPI assigned

Nov 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael K Kazak, M.D.NPI 1285732636

Title

Owner

Phone

(805) 922-8269

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michael Kazak MD INC Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Kazak, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Santa Maria, CA
  • NPI 1285732636
  Medicare reassignment NPD Authorized official
• Samara M Kazak, MD

  • Family Medicine Physician
  • Santa Maria, CA
  • NPI 1487230413
  Medicare reassignment NPD

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1528249232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 W MAIN ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934584238",
            "telephone_number": "805-922-8269",
            "fax_number": "805-349-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 W MAIN ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934584238",
            "telephone_number": "805-922-8269",
            "fax_number": "805-349-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL KAZAK MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "KAZAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-922-8269",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W22110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael Kazak MD INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Geriatric Medicine (Internal Medicine) Physician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Geriatric Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.