Individual provider Active NPI

Nitya Bakshi, MD

  • Pediatric Hematology & Oncology Physician
  • New Haven, CT
National Provider Identifier
1174764252
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
1.073742 Issued in CT
Practice address
1 Park St
New Haven, CT 06504-8901
Phone
(203) 785-4081
Fax
(203) 737-7635
NPI assigned
Mar 18, 2009
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 72257 GA
Pediatric Hematology & Oncology Physician 2080P0207X 1.073742 CT Primary

Addresses

Primary practice location

1 Park St
New Haven, CT 06504-8901

Mailing address

34 Tumblebrook Rd
Woodbridge, CT 06525-2535
Phone (305) 302-7093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160808001291 GA Practitioner - Pediatric Medicine 7911297635 Reassigns benefits to 1 organization
I20231019003097 CT Practitioner - Pediatric Medicine 7911297635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1.073742CTMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Yale University CurrentSince Oct 3, 2023 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jun 1, 2016 Accepting new patients
Yale University CurrentSince Oct 3, 2023 Accepting new patients
Emory Medical Care Foundation Inc Pediatric Hematology-Oncology CurrentSince Jun 1, 2016 Accepting new patients

Locations

35 Park St
New Haven, CT 06519
Phone (203) 200-2100

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1 Park St
North Haven, CT 06504
Phone (203) 785-2701

35 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 785-9500

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: nbakshi135228@choa.gadirect.net
  • Direct secure messaging: nbakshi632957@direct.ynhh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1174764252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 TUMBLEBROOK RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252535",
            "telephone_number": "305-302-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065048901",
            "telephone_number": "203-785-4081",
            "fax_number": "203-737-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKSHI",
        "first_name": "NITYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-18",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "GA",
            "license": "72257",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "CT",
            "license": "1.073742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.