Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. ALEXANDRA MAZO MD
NPI 1194202283
Pediatrics - Pediatric Nephrology in San Bernardino, CA

Q: What is Alexandra Mazo's NPI number?

The NPI number for Alexandra Mazo is 1194202283. It was assigned to this individual provider in the NPPES registry on July 23, 2018.

Q: What is Alexandra Mazo's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.

Q: When was this NPI record last updated?

The NPPES record for Alexandra Mazo was last updated on September 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.

Active since July 23, 2018PECOS Enrolled

250 E CAROLINE ST STE J, SAN BERNARDINO, CA 92408(909) 651-1904 Get Directions Write a Review

NPPES record last updated: September 22, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 22, 2026, Sep 2, 2026, Aug 18, 2023 and 4 more (7 updates tracked since 2018).

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About Dr. Alexandra Mazo Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ALEXANDRA MAZO MD (NPI 1194202283) is an individual pediatric nephrology provider in San Bernardino, California, licensed in California (A206585) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1194202283

Entity TypeIndividualFemale

Primary Taxonomy2080P0210X

Provider Legal NameDR. ALEXANDRA MAZOCredential: MD

Location Address250 E CAROLINE ST STE JSan Bernardino, CA 92408-3758

Mailing Address11175 Campus StLoma Linda, CA 92350-1700 · (909) 558-8626

Phone(909) 651-1904

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateJuly 23, 2018

Last NPPES UpdateSeptember 22, 20267 updates tracked since enumeration

NPPES CertifiedSeptember 22, 2026

✔ NPI 1194202283 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0210X

License✔ Licensed in CA · A206585

Definition

A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.

250 E CAROLINE ST STE J, San Bernardino, CA 92408

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Alexandra Mazo Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527420868

PECOS Enrollment IDI20230817002320

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BARBARA K ARIUE M.D.

Pediatrics (Pediatric Allergy/Immunology)