SAMUEL BALDAZO
NPI 1891371472
Student in an Organized Health Care Education/Training Program in Charlottesville, VA

Active since March 23, 2021PECOS Enrolled
1215 LEE ST, CHARLOTTESVILLE, VA 22908(434) 924-5321(434) 982-3816 Get Directions Write a Review

NPPES record last updated: March 23, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Samuel Baldazo NPPES

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

SAMUEL BALDAZO (NPI 1891371472) is an individual student in an organized health care education/training program in Charlottesville, Virginia and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891371472
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSAMUEL BALDAZO
Location Address1215 LEE STCharlottesville, VA 22908-0816
Mailing Address1215 Lee StCharlottesville, VA 22908-0816 · (434) 924-5321 · Fax (434) 982-3816
Fax(434) 982-3816
Sole ProprietorNo
Enumeration DateMarch 23, 2021
NPPES CertifiedMarch 23, 2021
NPI 1891371472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1215 LEE ST, Charlottesville, VA 22908

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Samuel Baldazo 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.

Other Providers at the Same Location NPPES 20

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

Nurse Practitioner
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Anesthesiology
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Emergency Medicine
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Anesthesiology
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Hospitalist
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Nurse Practitioner (Pediatrics)
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Dermatology
1215 LEE ST, BOX 800744
CHARLOTTESVILLE, VA 22908
Pediatrics (Pediatric Gastroenterology)
1215 LEE ST
CHARLOTTESVILLE, VA 22908

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 Samuel Baldazo's NPI number?

The NPI number for Samuel Baldazo is 1891371472. It was assigned to this individual provider in the NPPES registry on March 23, 2021.

Where is Samuel Baldazo located?

Samuel Baldazo practices at 1215 Lee St, Charlottesville, VA 22908. The listed phone number is (434) 924-5321.

What is Samuel Baldazo's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samuel Baldazo enrolled in Medicare?

Yes. Samuel Baldazo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samuel Baldazo was last updated on March 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.