Dimitri J Bacos, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A110160 Issued in CA

Practice address

1080 Emeline Ave
Santa Cruz, CA 95060-1966

Phone

(831) 454-4296

NPI assigned

Jan 12, 2010

Last updated

Feb 19, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Psychiatry

Education

Tufts University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of Santa CruzGroup PAC ID 7618872912, shared by 4 NPIs, 65 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dbacos169699@direct.ochin.org

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.

• County of Santa Cruz

  • Clinic/Center
  • Santa Cruz, CA
  • NPI 1659315430
  Medicare reassignment NPD
• County of Santa Cruz

  dba Watsonville Health Center

  • Federally Qualified Health Center (FQHC)
  • Watsonville, CA
  • NPI 1770709149
  Medicare reassignment NPD
• County of Santa Cruz

  dba Homeless Persons Health Project

  • Federally Qualified Health Center (FQHC)
  • Santa Cruz, CA
  • NPI 1285033514
  NPD
• County of Santa Cruz

  • Federally Qualified Health Center (FQHC)
  • Santa Cruz, CA
  • NPI 1578680310
  NPD (past)
• Puentes Al Sur

  dba Health Services Agency-Mental Health Division

  • Adult Mental Health Clinic/Center
  • Watsonville, CA
  • NPI 1992849012
  NPD (past)

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1760712814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACOS",
        "first_name": "DIMITRI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-12",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A110160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY, CALIFORNIA MEDICARE GROUP PTAN #",
            "identifier": "ZZZ91891Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY, CALIFORNIA MEDICARE GROUP PTAN #",
            "identifier": "ZZZ91892Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY, CALIFORNIA MEDI-CAL GROUP ID",
            "identifier": "FHC 700 44F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY, CALIFORNIA MEDI-CAL GROUP ID",
            "identifier": "FHC70042F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joselyn Leslie Aza-Hurtado
• Kathleen Azevedo
• Joshua N. Babad, M.D.
• Hannah Bach
• Cindy M Bacon, LM, CPM
• Isabel Baer-Modena
• Carly Joy Bagnall, PT, DPT
• Kriya Marion Bahn, MSW
• Barbara Bailey-Porter, LMFT
• Holly Bailey, N.P.

• Psychiatry Physician in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.