Individual provider Active NPI

Iffat Bhuiyan, MD

  • Psychiatry Physician
  • Marietta, GA
National Provider Identifier
1043590151
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
73943 Issued in GA
Practice address
2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone
(770) 644-1570
NPI assigned
Aug 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 73943 GA Primary

Addresses

Primary practice location

2540 Windy Hill Rd SE
Marietta, GA 30067-8605

Mailing address

2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone (770) 644-1570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191118002778 CA Practitioner - Psychiatry 8325277908 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73943GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Sep 18, 2019 Accepting new patients
Department of State Hospitals CurrentSince Sep 18, 2019 Accepting new patients
Department of State Hospitals Current Accepting new patients

Locations

3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Organizations & group practices 3

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": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1043590151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 WINDY HILL RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678605",
            "telephone_number": "770-644-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 WINDY HILL RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678605",
            "telephone_number": "770-644-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHUIYAN",
        "first_name": "IFFAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "73943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.