NPIMap

Individual provider Active NPI

Stefan Elazier

  • Family Medicine Physician
  • Los Banos, CA
National Provider Identifier
1669753240
Registry record updated Sep 13, 2022
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Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A109345 Issued in CA
Practice address
311 W I St
Los Banos, CA 93635-3479
Phone
(209) 826-2222
NPI assigned
Sep 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A109345 CA Primary

Addresses

Primary practice location

311 W I St
Los Banos, CA 93635-3479

Mailing address

311 W I St
Los Banos, CA 93635-3479
Phone (209) 826-2222

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
I20111027000910 CA Practitioner - Family Practice 1759554231 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
KD Medical Group IncGroup PAC ID 2860553468, 6 clinicians
Karthikeya Devireddy MD IncGroup PAC ID 3072566728, 10 clinicians

Practice addresses (Care Compare)

311 W I St
Los Banos, CA 93635-3479
Phone (209) 826-6444

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Salida, CA, CCN 057695
  • Careone Home Health and Hospice, Inc Home health agency, Salida, CA, CCN 059401
  • Covenant Care at Home Home health agency, Turlock, CA, CCN 057571
  • Memorial Hospital Los Banos Hospital, Los Banos, CA, CCN 050528
  • Los Banos Post Acute Nursing home, Los Banos, CA, CCN 055028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A109345CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Noble Group a Medical Corporation CurrentSince Sep 12, 2011 Accepting new patients
Rocket Doctor Practice Group, P.C. Family Medicine CurrentSince Nov 5, 2025 Accepting new patients
KD Medical Group Inc Family Medicine CurrentSince May 27, 2022 Accepting new patients
KD Medical Group Inc CurrentSince May 27, 2022 Accepting new patients
Karthikeya Devireddy MD Inc CurrentSince May 27, 2022 Accepting new patients
Dos Palos Apex Health Center Inc Past Accepting new patients
Sutter Gould Medical Foundation Family Medicine Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

8274 Melrose Ave
Los Angeles, CA 90046

311 W I St
Los Banos, CA 93635
Phone (209) 826-2222

311 W I St
Ste A
Los Banos, CA 93635

400 W I St
Ste A
Los Banos, CA 93635
Phone (209) 826-3200

311 W I St
#B
Los Banos, CA 93635
Phone (209) 826-2222

394 E Yosemite Ave
Merced, CA 95340
Phone (209) 383-3990

3144 G St
Ste 125
Merced, CA 95340
Phone (209) 383-3990

881 Dover Dr
Ste 250
Newport Beach, CA 92663
Phone (218) 203-5474

881 Dover Dr
Ste 200
Newport Beach, CA 92663

20311 SW Acacia St
Ste 140
Newport Beach, CA 92660
Phone (831) 777-4283

2219 Main St
Santa Monica, CA 90405
Phone (310) 800-1630

Interoperability endpoints

  • Direct secure messaging: stefan.elazier.3@3550.direct.athenahealth.com
  • Direct secure messaging: stefan.elazier.1@3550.direct.athenahealth.com

Organizations & group practices 8

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.

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": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1669753240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAZIER",
        "first_name": "STEFAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-08",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A109345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

Verify at the official NPI Registry.