Individual provider Active NPI

Rossano Luistro Bangasan, M.D.

  • Psychiatry Physician
  • Bakersfield, CA
National Provider Identifier
1659407955
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A82239 Issued in CA
Practice address
1600 E Belle Ter
Bakersfield, CA 93307-3871
Phone
(661) 635-2950
Fax
(661) 635-2983
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A82239 CA Primary

Addresses

Primary practice location

1600 E Belle Ter
Bakersfield, CA 93307-3871

Mailing address

PO Box 1000
Bakersfield, CA 93302-1000
Phone (661) 635-2950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040324000661 CA Practitioner - Psychiatry 4486545720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of KernGroup PAC ID 7810887205, 75 clinicians

Practice addresses (Care Compare)

3715 Columbus St
Bakersfield, CA 93306-2719
Phone (661) 868-6600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A82239CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Kern Psychiatry CurrentSince Jun 24, 2018 Accepting new patients
County of Kern Psychiatry CurrentSince Jun 24, 2018 Accepting new patients
County of Kern Psychiatry Current Accepting new patients

Locations

2525 N Chester Ave
Bakersfield, CA 93308
Phone (661) 328-4295

1830 Flower St
Bakersfield, CA 93305
Phone (661) 326-2248

1600 E Belle Ter
Bakersfield, CA 93307
Phone (661) 635-2950

2151 College Ave
Bakersfield, CA 93305
Phone (661) 868-8080

3715 Columbus St
Bakersfield, CA 93306
Phone (661) 868-7151

930 F St
Wasco, CA 93280
Phone (661) 674-3377

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1659407955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933021000",
            "telephone_number": "661-635-2950",
            "fax_number": "661-635-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E BELLE TER",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933073871",
            "telephone_number": "661-635-2950",
            "fax_number": "661-635-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGASAN",
        "first_name": "ROSSANO",
        "middle_name": "LUISTRO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A82239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.