Polyclinic Medical Center, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

CMM70507H Issued in CA

Legal business name

POLYCLINIC MEDICAL CENTER, INC.

Practice address

2145 Niles St
Bakersfield, CA 93305-5007

Phone

(661) 327-5984

Fax

(661) 327-2541

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Kamrun P Naher, M.D.NPI 1578723110

Title

Director

Phone

(661) 327-5984

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamrun Naher, M.D.

  • Family Medicine Physician
  • Bakersfield, CA
  • NPI 1578723110
  Medicare reassignment Care Compare group NPD Authorized official
• Vicente Audoni Benavidez, PA-C

  • Medical Physician Assistant
  • Bakersfield, CA
  • NPI 1356615421
  Medicare reassignment Care Compare group
• Alexandra CL Dzikowski

  • Nurse Practitioner
  • Bakersfield, CA
  • NPI 1508582610
  Medicare reassignment NPD
• Antoinette M Placenti, N.P.

  • Nurse Practitioner
  • Bakersfield, CA
  • NPI 1720144405
  Medicare reassignment NPD
• Elizabeth Ann Lopez, FNP-C

  • Family Nurse Practitioner
  • Post Falls, ID
  • NPI 1568657302

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564531200000",
    "number": "1750308656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933055007",
            "telephone_number": "661-327-5984",
            "fax_number": "661-327-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933055007",
            "telephone_number": "661-327-5984",
            "fax_number": "661-327-2541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2145 Niles St",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933055007",
            "country_code": "US",
            "telephone_number": "661-327-5984",
            "fax_number": "661-327-2541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POLYCLINIC MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2019-07-31",
        "status": "A",
        "authorized_official_last_name": "NAHER",
        "authorized_official_first_name": "KAMRUN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "661-327-5984",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "CMM70507H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70507H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Alan Poles, MD
• Jezel Poliran, NONE
• Jacqueline Polonio, CATC
• Emily Veronica Polovick Moulds, OTR
• Polyclinic Medical Center, Inc.
• Cheryl Lynn Polyudhapoom, LCSW
• Rhiannon Lavon Pomeroy Solorzano
• Ashley Angie Ponce
• Felicia Ponce
• Isabella Faith Joyous Ponce

• Family Medicine Physician in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.