Nishith Bhattacharyya, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

25MA0669860 Issued in NJ

Practice address

2130 Millburn Avenue
Pediatric Surgery Group
Maplewood, NJ 07040

Phone

(888) 287-3652

Fax

(973) 549-6079

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Josephs Medical Group PC

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1205425519
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1003854092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 785361",
            "address_2": "PEDIATRIC SURGERY GROUP",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19178",
            "telephone_number": "888-287-3652",
            "fax_number": "973-549-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVENUE",
            "address_2": "PEDIATRIC SURGERY GROUP",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "07040",
            "telephone_number": "888-287-3652",
            "fax_number": "973-549-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATTACHARYYA",
        "first_name": "NISHITH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NJ",
            "license": "25MA0669860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7558406",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chantal Berry, CNM
• Linda Berry, LCSW
• Allison Berwald, LCSW
• Colin A Bethel, MD
• Omar M. Bey, M.D.
• Jacqueline Bilikiewicz, LMHC
• Bill Powell, MSW, PA
• Christian A Blackwell
• Zoe E. Blanchard, MSW, LSW
• Kenneth B Blatt, M.D.

• Pediatric Surgery Physician in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Pediatric Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.