NPIMap

Organization Active NPI

St. John Critical Care Medical Group, Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Bakersfield, CA
National Provider Identifier
1528407012
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A89185 Issued in CA
Legal business name
ST. JOHN CRITICAL CARE MEDICAL GROUP, INC
Practice address
3805 San Dimas St
Ste B
Bakersfield, CA 93301-5724
Phone
(661) 326-9999
Fax
(661) 326-9011
NPI assigned
Jun 18, 2013
Last updated
Jun 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Dr. Hany S Aziz, MDNPI 1659340339
Title
Owner
Phone
(661) 326-9999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A89185 CA Primary

Addresses

Primary practice location

3805 San Dimas St
Ste B
Bakersfield, CA 93301-5724

Mailing address

PO Box 11134
Bakersfield, CA 93389-1134
Phone (661) 326-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130905000067 CA Part B Supplier - Clinic/Group Practice 3476796780 Receives reassigned benefits from 16 practitioners
Practice locations: Bakersfield, CA

National Provider Directory

National Provider Directory

Locations

3805 San Dimas St
Bakersfield, CA 93301
Phone (661) 324-7300

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1528407012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11134",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933891134",
            "telephone_number": "661-326-9999",
            "fax_number": "661-326-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 SAN DIMAS ST",
            "address_2": "STE B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933015724",
            "telephone_number": "661-326-9999",
            "fax_number": "661-326-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN CRITICAL CARE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "AZIZ",
        "authorized_official_first_name": "HANY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-326-9999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A89185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.