Mark Burrell Bazalgette, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

A46290 Issued in CA

Practice address

165 Rowland Way Ste 200
Novato, CA 94945-5055

Phone

(415) 827-0344

Fax

(415) 924-2661

NPI assigned

Aug 31, 2006

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 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: markbazalgette@whwli-ca.direct.office.nextgen.com

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.

• East Bay Area Quality Health Corporation

  • Family Medicine Physician
  • Oakland, CA
  • NPI 1295182335
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1891806014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD",
            "address_2": "SUITE 101",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391143",
            "telephone_number": "415-924-2515",
            "fax_number": "415-924-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ROWLAND WAY STE 200",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455055",
            "telephone_number": "415-827-0344",
            "fax_number": "415-924-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZALGETTE",
        "first_name": "MARK",
        "middle_name": "BURRELL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A46290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A462900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bashar Hinnawi DMD Inc
• Michelle Baumgartner
• Bay Area Community Resources, Inc.
• Bay Area Community Resources, Inc.
• Bay Area Surgical Specialists, Inc a Medical Corporation
• Irina Bazavan, NP
• Jolaine Beal, MD, MPH
• Ariel Beauhaire, M.S., CCC-SLP
• Joann Rupert Behm, RN, PHN
• Bell and Ellenberg Marriage Counseling, Inc.

• All providers in Novato, CA
• Colon & Rectal Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.