GINO JOSE BARDI LOLA M.D.
NPI 1700230109
Pediatrics in Douglas, AZ

Q: What is Gino Bardi Lola's NPI number?

The NPI number for Gino Bardi Lola is 1700230109. It was assigned to this individual provider in the NPPES registry on April 21, 2016.

Q: What is Gino Bardi Lola's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Gino Bardi Lola was last updated on February 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 21, 2016PECOS Enrolled

815 E 15TH ST, DOUGLAS, AZ 85607(520) 364-5437 Get Directions Write a Review

NPPES record last updated: February 14, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Gino Jose Bardi Lola M.d. NPPES

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

GINO JOSE BARDI LOLA M.D. (NPI 1700230109) is an individual pediatrics provider in Douglas, Arizona, licensed in Arizona (65304) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700230109

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameGINO JOSE BARDI LOLACredential: M.D.

Location Address815 E 15TH STDouglas, AZ 85607-1631

Mailing Address1205 N F AveDouglas, AZ 85607-1920 · (520) 459-3110

Phone(520) 364-5437

Sole ProprietorNo

Enumeration DateApril 21, 2016

Last NPPES UpdateFebruary 14, 2024

NPPES CertifiedJanuary 24, 2024

✔ NPI 1700230109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in AZ · 65304

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

815 E 15TH ST, Douglas, AZ 85607

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gino Jose Bardi Lola M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Gino Bardi Lola reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Chiricahua Community Health Centers, Inc

Same address

Federally Qualified Health Center (FQHC)

815 15TH STREET
Douglas, AZ 85607

Reassigned Medicare billing, Arizona enrollment
65 clinicians in this Medicare group

NPI 1174820898 (520) 364-5437

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85607 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

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

BRENDA KAY JAMES RD/LD

Dietitian, Registered