IAN CHRISTIAN BRANDON BIDEGARAY DO
NPI 1912649666
Student in an Organized Health Care Education/Training Program in Miami, FL

Q: What is Ian Brandon Bidegaray's NPI number?

The NPI number for Ian Brandon Bidegaray is 1912649666. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Q: What is Ian Brandon Bidegaray's specialty?

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

Active since April 12, 2022PECOS Enrolled

15955 SW 96TH ST STE 200, MIAMI, FL 33196(786) 467-3140 Get Directions Write a Review

NPPES record last updated: April 26, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 26, 2022, Apr 12, 2022 (2 updates tracked since 2022).

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About Ian Christian Brandon Bidegaray Do NPPES

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

IAN CHRISTIAN BRANDON BIDEGARAY DO (NPI 1912649666) is an individual student in an organized health care education/training program in Miami, Florida and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912649666

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameIAN CHRISTIAN BRANDON BIDEGARAYCredential: DO

Location Address15955 SW 96TH ST STE 200Miami, FL 33196-1272

Mailing Address4263 Losco Rd Apt 111Jacksonville, FL 32257-1456 · (786) 251-7111

Phone(786) 467-3140

Sole ProprietorNo

Enumeration DateApril 12, 2022

Last NPPES UpdateApril 26, 20222 updates tracked since enumeration

NPPES CertifiedApril 26, 2022

✔ NPI 1912649666 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

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.

15955 SW 96TH ST STE 200, Miami, FL 33196

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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 (PECOS)

Ian Christian Brandon Bidegaray Do 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.

DR. DAYANA BALSALOBRE DO

Student in an Organized Health Care Education/Training Program