Individual provider Active NPI

Nahiris Maria Bahamon, M.D

  • Pediatrics Physician
  • Hesperia, CA
National Provider Identifier
1750762886
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
290796 Issued in CA
Practice address
16453 Bear Valley Rd
Hesperia, CA 92345-1752
Phone
(180) 072-2477
NPI assigned
Jun 15, 2015
Last updated
Feb 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 290796 CA Primary

Addresses

Primary practice location

16453 Bear Valley Rd
Hesperia, CA 92345-1752

Mailing address

16453 Bear Valley Rd
Hesperia, CA 92345-1752
Phone (180) 072-2477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220124002143 MA Practitioner - Pediatric Medicine 8022315134 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290796CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Community Health Center, Inc. CurrentSince Dec 21, 2022 Accepting new patients
Neighborhealth Corporation Current Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Nov 18, 2021 Accepting new patients
Lowell Community Health Center, Inc. CurrentSince Dec 21, 2022 Accepting new patients
Lowell Community Health Center, Inc. Current Accepting new patients

Locations

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

101 Jackson St
Lowell, MA 01852
Phone (978) 459-8656

161 Jackson St
Lowell, MA 01852
Phone (978) 746-7867

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1750762886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16453 BEAR VALLEY RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451752",
            "telephone_number": "180-072-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16453 BEAR VALLEY RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451752",
            "telephone_number": "180-072-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHAMON",
        "first_name": "NAHIRIS",
        "middle_name": "MARIA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "290796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hesperia, CA

Sources for this page

Verify at the official NPI Registry.