NPIMap

Individual provider Active NPI

Michael Bazel, MD

  • Emergency Medicine Physician
  • Bell, CA
National Provider Identifier
1598712978
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G78177 Issued in CA
Practice address
4001 Florence Ave
Bell, CA 90201-3403
Phone
(323) 562-0595
Fax
(323) 562-0595
NPI assigned
May 30, 2006
Last updated
Jan 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G78177 CA Primary

Addresses

Primary practice location

4001 Florence Ave
Bell, CA 90201-3403

Mailing address

4001 Florence Ave
Bell, CA 90201-3403
Phone (323) 562-0595

Other identifiers 2

IdentifierTypeStateIssuer
00G781771MedicaidCA
00G781770MedicaidCA

Other names 1

  • Dr. Michael Bazelyansky Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031103000705 CA Practitioner - Emergency Medicine 8527970029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5352 Laurel Canyon Blvd
Suite 110
North Hollywood, CA 91607-4938
Phone (818) 206-2655

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
78177CAMDClinical Social Worker
G78177CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Corona Regional Emergency Medical Associates Inc Emergency Medicine CurrentSince Mar 10, 2018 Accepting new patients
First Health Medical Group, Inc CurrentSince Mar 5, 2011 Accepting new patients
California Em-I Medical Services Emergency Medicine Past Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

5352 Laurel Canyon Blvd
Ste 110
Valley Village, CA 91607
Phone (310) 431-4926

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1598712978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 FLORENCE AVE",
            "city": "BELL",
            "state": "CA",
            "postal_code": "902013403",
            "telephone_number": "323-562-0595",
            "fax_number": "323-562-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 FLORENCE AVE",
            "city": "BELL",
            "state": "CA",
            "postal_code": "902013403",
            "telephone_number": "323-562-0595",
            "fax_number": "323-562-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZEL",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G78177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G781771",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G781770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "BAZELYANSKY",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bell, CA

Sources for this page

Verify at the official NPI Registry.