Individual provider Active NPI

Roland Egon Bastian, M.D.

  • Emergency Medicine Physician
  • Thousand Oaks, CA
National Provider Identifier
1982634242
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G83563 Issued in CA
Practice address
215 W Janss Rd
Thousand Oaks, CA 91360-1847
Phone
(805) 370-4435
Fax
(805) 379-5579
NPI assigned
Jul 3, 2006
Last updated
Jul 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G83563 CA Primary

Addresses

Primary practice location

215 W Janss Rd
Thousand Oaks, CA 91360-1847

Mailing address

PO Box 661147
Arcadia, CA 91066-1147
Phone (626) 447-0296

Other identifiers 1

IdentifierTypeStateIssuer
00G835630MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050119000563 CA Practitioner - Emergency Medicine 0042269821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Physicians of California Medical Group IncGroup PAC ID 8224945084, 92 clinicians

Practice addresses (Care Compare)

215 W Janss Rd
Thousand Oaks, CA 91360-1847
Phone (805) 497-2727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G83563CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Robles Emergency Physicians Medical Group Emergency Medicine CurrentSince Dec 1, 2004 Accepting new patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Valley Emergency Medical Associates Emergency Medicine Past Accepting new patients

Locations

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1982634242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661147",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910661147",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W JANSS RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601847",
            "telephone_number": "805-370-4435",
            "fax_number": "805-379-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIAN",
        "first_name": "ROLAND",
        "middle_name": "EGON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G83563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G835630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.