Organization Active NPI

Bakht Roshan MD, a Professional Corp

  • Infectious Disease Physician
  • Madera, CA
National Provider Identifier
1164179552
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
BAKHT ROSHAN MD, A PROFESSIONAL CORP
Practice address
924 Emily Way
Madera, CA 93637-5647
Phone
(559) 203-5125
NPI assigned
Mar 4, 2022
Last updated
Jan 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Bakht Roshan, M.D.NPI 1639201502
Title
President
Phone
(617) 319-7737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X NU Primary

Addresses

Primary practice location

924 Emily Way
Madera, CA 93637-5647

Mailing address

9594 N Larkspur Ave
Fresno, CA 93720-4620
Phone (617) 319-9021

Other practice location 1

7035 N Maple Ave Ste 101
Fresno, CA 93720-8026
Phone (559) 203-5125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220330002386 CA Part B Supplier - Clinic/Group Practice 6002202090 Receives reassigned benefits from 1 practitioner
Practice locations: Madera, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1164179552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9594 N LARKSPUR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937204620",
            "telephone_number": "617-319-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 EMILY WAY",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375647",
            "telephone_number": "559-203-5125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7035 N Maple Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937208026",
            "country_code": "US",
            "telephone_number": "559-203-5125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BAKHT ROSHAN MD, A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "ROSHAN",
        "authorized_official_first_name": "BAKHT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-319-7737",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.