Individual provider Active NPI

Bita Deyhimpanah, M.D.

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1013159862
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
445 E 68TH St Apt 10N
New York, NY 10065-6331
Phone
(917) 776-9173
NPI assigned
Mar 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

445 E 68TH St Apt 10N
New York, NY 10065-6331

Mailing address

445 E 68TH St Apt 10N
New York, NY 10065-6331
Phone (917) 776-9173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20220203002056 FL Practitioner - Internal Medicine 6204973217 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
CTD Network LLC CurrentSince Nov 25, 2022 Accepting new patients

Locations

1805 James L Redman Pkwy
Ste 201
Plant City, FL 33563
Phone (305) 721-1101

1805 James L Redman Pkwy
#5412
Plant City, FL 33563

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1013159862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E 68TH ST APT 10N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656331",
            "telephone_number": "917-776-9173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E 68TH ST APT 10N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656331",
            "telephone_number": "917-776-9173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYHIMPANAH",
        "first_name": "BITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.