Nilay Bhasker Thaker, D.O.
Individual provider Active NPI Adult Medicine Physician · Martinsburg, WV
NPI 1124275334 · NPPES record last updated Aug 22, 2024
Key facts
- NPI
- 1124275334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Medicine Physician 207QA0505X
- License
- OS022728 (PA)
- Practice address
- 484 Williamsport Pike # 151
Martinsburg, WV 25404-5707 - Phone
- (630) 730-0302
- NPI assigned
- Aug 20, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Midwestern University, Chicago College of Osteopathic Med, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- PA Post Acute Services PC
Practice addresses (Care Compare)
100 Heartland Dr
Beckley, WV 25801-2655
Phone (513) 489-7100
1263 S George St
Charles Town, WV 25414-4384
Phone (304) 725-6575
183 Holbrook Rd
Buckhannon, WV 26201-0029
Phone (513) 489-7100
456 Autumn Acres Rd
Berkeley Springs, WV 25411-3202
Phone (513) 489-7100
Hospital & facility affiliations
- Hospice of the Panhandle, Inc
- Valley Health War Memorial Hospital
- Jefferson Medical Center
- Winchester Medical Center
- Berkeley Springs Healthcare Center
- Willow Tree Healthcare Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101007000466 | MD | Practitioner - Family Practice |
5395869861 | Reassigns benefits to 1 organization |
| I20210630002337 | WV | Practitioner - Family Practice | 5395869861 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS022728 | PA | MD | Adult Medicine Physician |
| 3634 | WV | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Womencare, Inc | Current | Accepting new patients | |
| Womencare Inc | Current |
Accepting new patients | |
| PA Post Acute Services PC | Current |
Accepting new patients | |
| Womencare, Inc | Current |
Accepting new patients | |
| Reliable Documents Solutions, LLC | Current | Accepting new patients | |
| Autumn Leasing Co., LLC | Past | Accepting new patients | |
| Blue Ridge Nursing, LLC | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
2525 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 367-9100
105 Time Sq
Salisbury, MD 21801
Phone (410) 749-2474
183 Holbrook Rd
Buckhannon, WV 26201
Phone (304) 472-3280
12 Kanawha Ter
Saint Albans, WV 25177
Phone (304) 201-1130
Interoperability endpoints
- nilay.thaker.2@27404.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | OS022728 | PA | Yes |
| Adult Medicine Physician | 207QA0505X | 3634 | WV |
Addresses
Primary practice location
484 Williamsport Pike # 151
Martinsburg, WV 25404-5707
Mailing address
6030 Daybreak Circle
Suite A150 PMB 263
Clarksville, MD 21029-1638
Phone (630) 730-0302
Other providers in Martinsburg, WV
- Shannon Teets
- Destini Telke
- Agnes Tenly
- Regina Terry-Jackson
- Elizabeth Thacker
- Thane S. Farmer, DDS
- The Feelings Nest PLLC
- The Giant Company, LLC
- The Martinsburg Work Center II
- Thera-Pharm Solutions LLC
All providers in Martinsburg, WV · Adult Medicine Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.