Individual provider Active NPI

Behdokht Daneshvar, MD

  • Internal Medicine Physician
  • Northfield, NJ
National Provider Identifier
1093745473
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA069585 Issued in NJ
Practice address
1015 New Rd
2ND Floor
Northfield, NJ 08225-1660
Phone
(609) 485-0300
Fax
(609) 646-7140
NPI assigned
Jul 3, 2006
Last updated
Feb 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA069585 NJ Primary
Hospitalist Physician 208M00000X 25MA06958500 NJ

Addresses

Primary practice location

1015 New Rd
2ND Floor
Northfield, NJ 08225-1660

Mailing address

1015 New Rd
2ND Floor
Northfield, NJ 08225-1660
Phone (609) 485-0300

Other identifiers 1

IdentifierTypeStateIssuer
8024804MedicaidNJ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091020000553 NJ Practitioner - Internal Medicine 2062559248 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA069585NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Behdokht Daneshvar, LLC Internal Medicine CurrentSince Jun 9, 2012 Accepting new patients
Atlanticare Physician Group CurrentSince Dec 29, 2015 Accepting new patients
Atlanticare Urgent Care Physicians LLC Past Accepting new patients
Hebrew Old Age Center of Atlantic City Past Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

1015 New Rd
Fl 2
Northfield, NJ 08225
Phone (609) 441-8071

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

408 Bethel Rd
Ste C-2
Somers Point, NJ 08244
Phone (609) 788-0199

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1093745473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 NEW RD",
            "address_2": "2ND FLOOR",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251660",
            "telephone_number": "609-485-0300",
            "fax_number": "609-646-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 NEW RD",
            "address_2": "2ND FLOOR",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251660",
            "telephone_number": "609-485-0300",
            "fax_number": "609-646-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANESHVAR",
        "first_name": "BEHDOKHT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA069585",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA06958500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8024804",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, NJ

Sources for this page

Verify at the official NPI Registry.