NPIMap

Individual provider Active NPI

Varsha Kishore, D.O.

  • Family Medicine Physician
  • Binghamton, NY
National Provider Identifier
1083062103
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2978261 Issued in NY
Practice address
17 Chenango Bridge Rd
Binghamton, NY 13901
Phone
(607) 772-2995
NPI assigned
May 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K260839027630 MD
Family Medicine Physician 207Q00000X 2978261 NY Primary

Addresses

Primary practice location

17 Chenango Bridge Rd
Binghamton, NY 13901

Mailing address

17 Chenango Bridge Rd
Binghamton, NY 13901-1233

Other practice location 1

14114 Forest Ridge Dr
North Potomac, MD 20878-4824
Phone (301) 807-6842

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address varsha.kishore@direct.lourdes.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190802000401 NY Practitioner - Family Practice 2466788146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

169 Riveride Dr
Binghamton, NY 13905-4246

17 Chenango Bridge Rd
Binghamton, NY 13901-1233
Phone (607) 772-2995

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K260839027630MDMDFamily Medicine Physician
2978261NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. Family Medicine CurrentSince Sep 18, 2019 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Sep 18, 2019 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

17 Chenango Bridge Rd
Binghamton, NY 13901
Phone (607) 772-2995

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

Interoperability endpoints

  • Direct secure messaging: vkishore196828@direct-guthrie.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1083062103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CHENANGO BRIDGE RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139011233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CHENANGO BRIDGE RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13901",
            "telephone_number": "607-772-2995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14114 Forest Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "North Potomac",
            "state": "MD",
            "postal_code": "208784824",
            "country_code": "US",
            "telephone_number": "301-807-6842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISHORE",
        "first_name": "VARSHA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "K260839027630",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "2978261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "varsha.kishore@direct.lourdes.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "17 Chenango Bridge Rd",
            "city": "Binghamton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "13901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.