Active NPI
Bahram Jahanbakhsh, M.D.
- Anesthesiology Physician
- Staten Island, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 279538
- Practice address
- 475 Seaview Ave
Staten Island, NY 10305-3436 - Phone
- (718) 226-9292
- NPI assigned
- May 17, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | 279538 | NY | |
| Anesthesiology Physician | 207L00000X | 279538 | NY | Primary |
Addresses
Primary practice location
475 Seaview Ave
Staten Island, NY 10305-3436
Mailing address
175 Adams St Apt 9H
Brooklyn, NY 11201-1817
Other practice location 1
622 W 168th St
New York, NY 10032-3720
Phone (212) 305-2069
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
393 E Walnut 3Rd FL
Pasedena, CA 91188-0001
393 E Walnut St FL
3 PHR Group Provider Enrollment Unit
Pasadena, CA 91188-0001
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Harlem Medical Associates PC | Current | Accepting new patients | |
| Downtown Bronx Medical Associates PC | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000
234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874
506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000
45 Research Way
Ste 206
Setauket, NY 11733
Phone (631) 575-9300
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 and National Provider Directory roles.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bronx, NY
- NPI 1689618407
-
- General Practice Physician
- New York, NY
- NPI 1487957692
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Inglewood, CA
- NPI 1821635079
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1164715686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 ADAMS ST APT 9H",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053436",
"telephone_number": "718-226-9292"
}
],
"practiceLocations": [
{
"address_1": "622 W 168th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100323720",
"country_code": "US",
"telephone_number": "212-305-2069",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAHANBAKHSH",
"first_name": "BAHRAM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-17",
"last_updated": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "NY",
"license": "279538",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "279538",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "6041 Cadillac Ave",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900341702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.