DIMITRI BAZIN PA
NPI 1174067425
Physician Assistant - Medical in New York, NY
About Dimitri Bazin Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DIMITRI BAZIN PA (NPI 1174067425) is an individual medical provider in New York, New York, licensed in New York (P04485) and active in the NPI registry since December 2016. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dimitri Bazin Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dimitri Bazin's NPI number?
The NPI number for Dimitri Bazin is 1174067425. It was assigned to this individual provider in the NPPES registry on December 6, 2016.
Where is Dimitri Bazin located?
Dimitri Bazin practices at 3418 Broadway Ofc 2, New York, NY 10031. The listed phone number is (212) 283-2099.
What is Dimitri Bazin's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Dimitri Bazin enrolled in Medicare?
Yes. Dimitri Bazin is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Dimitri Bazin was last updated on December 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dimitri Bazin, PA · NPI 1174067425
Medical physician in New York, New York. Individual provider, active in the CMS NPPES registry since December 6, 2016.
## Identity
- **NPI:** 1174067425 (Entity type: Individual)
- **Enumerated:** December 6, 2016
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** P04485 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 3418 BROADWAY OFC 2, New York, NY 10031-7408
- **Phone:** (212) 283-2099
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** December 6, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1174067425) · Data from the CMS NPPES public registry.