NPIMap

Organization Active NPI

Visavis Health Care Medical Group of Ma PLLC

  • Family Medicine Physician
  • Danvers, MA
National Provider Identifier
1053190223
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VISAVIS HEALTH CARE MEDICAL GROUP OF MA PLLC
Practice address
15 Kirkbride Drive
Danvers, MA 01923
Phone
(929) 491-7333
NPI assigned
Sep 26, 2023
Last updated
Oct 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Rekha BhandariNPI 1023035466
Title
Owner
Phone
(212) 734-6621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

15 Kirkbride Drive
Danvers, MA 01923

Mailing address

831 Bedford Ave Ste 530
Brooklyn, NY 11205-2801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231114003523 MA Part B Supplier - Clinic/Group Practice 5092162966 Receives reassigned benefits from 37 practitioners
Practice locations: Danvers, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1053190223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 BEDFORD AVE STE 530",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 KIRKBRIDE DRIVE",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "01923",
            "telephone_number": "929-491-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISAVIS HEALTH CARE MEDICAL GROUP OF MA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "BHANDARI",
        "authorized_official_first_name": "REKHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-734-6621"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.