KEVIN ANTHONY BAZAN (D.P.T.) – Physical Therapist, NPI 1912447244

KEVIN ANTHONY BAZAN (D.P.T.) is a healthcare provider. based in Saint johns, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials D.P.T.. They hold a License No. 5501013922 (MI). The NPI Number for KEVIN ANTHONY BAZAN (D.P.T.) is 1912447244

Main info

Male
19 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN ANTHONY BAZAN (D.P.T.)
NPI
1912447244
Phone
(989) 224-3000
Address
1005 S US HIGHWAY 27 STE 100
Enumeration Date
6 March 2017
Last Update Date
25 June 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
9897238781
Graduation Year
2007 (19 years ago)
PAC ID
2567747041
Group Practice PAC ID
6204730393
Professional Enrollment ID
I20170323002475
Address ID
MI488679053OW1697XMXXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for KEVIN ANTHONY BAZAN (D.P.T.)

  • 1005 S US HIGHWAY 27 STE 100

    SAINT JOHNS, MI 488792423

    Phone: (989) 224-3000

    Fax: (989) 224-1424

    Type: Mailing

  • 790 REMINGTON BLVD

    BOLINGBROOK, IL 604404909

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-03-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170323002475IPhysical Therapist In Private PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities34516$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes21115$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes10712$0
View full utilization report →

Insurance plans in this area (ZIP 48879)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204730393View full group profile
NameSpecialtyState
-IL
Physical Therapist In Private PracticeIL
-IL
Occupational Therapist In Private PracticeMI
-MI
-MI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

What federal number belongs to KEVIN ANTHONY BAZAN (D.P.T.)?
The federal identifier for KEVIN ANTHONY BAZAN (D.P.T.) is NPI 1912447244.
Is KEVIN ANTHONY BAZAN (D.P.T.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize KEVIN ANTHONY BAZAN (D.P.T.)'s specialty in plain language?
Clinically, the directory lists KEVIN ANTHONY BAZAN (D.P.T.) with Physical Therapist. Clinical services aligned with this taxonomy classification.
What location shows for KEVIN ANTHONY BAZAN (D.P.T.)?
We surface Saint Johns, Michigan for KEVIN ANTHONY BAZAN (D.P.T.) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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