Organization Active NPI

Bahta and Associates Inc

  • Infectious Disease Physician
  • Pembroke Pines, FL
National Provider Identifier
1124220967
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
BAHTA AND ASSOCIATES INC
Practice address
10794 Pines Blvd Ste 203
Pembroke Pines, FL 33026-3920
Phone
(954) 392-5696
Fax
(954) 392-5668
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Authorized official

Name
Dr. Irene Fadullon Bahta, MD
Title
President
Phone
(954) 392-5696

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X
Infectious Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

10794 Pines Blvd Ste 203
Pembroke Pines, FL 33026-3920

Mailing address

PO Box 260101
Pembroke Pines, FL 33026-7101
Phone (954) 392-5696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050527000108 FL Part B Supplier - Clinic/Group Practice 0547202723 Receives reassigned benefits from 2 practitioners
Practice locations: Pembroke Pines, FL

National Provider Directory

National Provider Directory

Locations

10794 Pines Blvd
Ste 203
Pembroke Pines, FL 33026
Phone (954) 392-5696

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1124220967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330267101",
            "telephone_number": "954-392-5696",
            "fax_number": "954-392-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD STE 203",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-392-5696",
            "fax_number": "954-392-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAHTA AND ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "FADULLON BAHTA",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-392-5696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.