Bagum Karimullah Gulshad, MSN RN AGNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

309424 Issued in NY

Practice address

101 Dates Dr
Ithaca, NY 14850-1383

Phone

(607) 272-4011

NPI assigned

Oct 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Chestnut Health of Illinois LLC

  • Internal Medicine Physician
  • Elgin, IL
  • NPI 1588043939

  IL

  Medicare reassignment NPD
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643

  IL

  Medicare reassignment NPD
• Cloud Health Medical Group, P.a.

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1528744935
  NPD (past)
• Batwatch Medical Group, LLC

  • Public Health & General Preventive Medicine Physician
  • Surprise, AZ
  • NPI 1114721321
  NPD (past)

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1154963544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-272-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-272-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARIMULLAH GULSHAD",
        "first_name": "BAGUM",
        "credential": "MSN RN AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.cayugamed.org",
            "affiliation": "N",
            "address_1": "101 Dates Dr",
            "city": "Ithaca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148501383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristna Kapur, D.D.S.
• Fredric Kardon, MD
• Karen Laface MD PLLC
• Shantell Kargbeh, PA
• Hannah S Karimi
• Alexandra M Karnow, DO
• Kathryn Marie Karpinski, D.D.S.
• Patricia Marie Karr-Segal, LCSW
• Katherine Durrant LCSW PLLC
• Kathleen Lacson, NP

• All providers in Ithaca, NY
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.