Mark Tavita Dagdagan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C42621 Issued in CA

Practice address

5925 Truxtun Ave
Bakersfield, CA 93309-0432

Phone

(661) 638-2273

Fax

(661) 638-2288

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Marcelino Tavita Dagdagan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Family Practice

Education

Other, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (2 of 3)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Centric Health

  • Internal Medicine Physician
  • Bakersfield, CA
  • NPI 1578076501
  NPD
• Centric Health

  • Cardiovascular Disease Physician
  • Bakersfield, CA
  • NPI 1831248236
  NPD

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1831180587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1139",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933021139",
            "telephone_number": "661-371-2796",
            "fax_number": "661-438-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 TRUXTUN AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090432",
            "telephone_number": "661-638-2273",
            "fax_number": "661-638-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGDAGAN",
        "first_name": "MARK",
        "middle_name": "TAVITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C42621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAL. MEDICARE PROVIDER NU",
            "identifier": "00C426210",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94499024",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCELINO",
            "last_name": "DAGDAGAN",
            "middle_name": "TAVITA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carlos Miguel D'Assumpcao, MD
• Steffi L D'Souza, M.D.
• Lisa Dabanian, D.O.
• Andrea Dabrushman
• Ebenezer Dadzie, MD
• Meghan Marie Dague, FNP-C
• Scott Holbrook Dahlquist, D.D.S.
• Marcia Diane Dahm, P.T.
• Janis Penalosa Daigan
• Branden Lee Dailey, DDS

• All providers in Bakersfield, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.