Kaitlin Jean Bazan

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

1168775 Issued in TX

Practice address

2400 Round Rock Ave
Round Rock, TX 78681-4004

Phone

(214) 493-6228

NPI assigned

Feb 29, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Texas Tech University Health Science Center School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718
• St David'S Medical Center Hospital, Austin, TX, CCN 450431

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Ipc Healthcare Services of Texas, PLLC

  • Hospitalist Physician
  • San Antonio, TX
  • NPI 1023403011

  TX

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Davids Healthcare Partnership LP LLP

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1649223645

  Hospital

  Care Compare affiliation
• St. Davids Healthcare Partnership, L.P., LLP

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1720033947

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1598522153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7806 BRIJETTA DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750345482",
            "telephone_number": "214-493-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ROUND ROCK AVE",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814004",
            "telephone_number": "214-493-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZAN",
        "first_name": "KAITLIN",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1168775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Lee Baughn
• Audrey Ann Baum, WHNP-BC
• Bay Area Allergy PA
• Baylor Scott & White Health Enterprises, Inc.
• Baylor Scott and White
• Josselyn Kellie Bazor, LBSW
• Be Well MD PLLC
• Gary J Beach, MD
• Danielle C Beachler, M.D.
• Beacon Home Healthcare LLC

• All providers in Round Rock, TX
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.