Individual provider Active NPI

Jay M Bhatt, M.D.

  • Pediatric Otolaryngology Physician
  • Orange, CA
National Provider Identifier
1174880496
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
A126898 Issued in CA
Practice address
1010 W la Veta Ave Ste 640
Orange, CA 92868-4306
Phone
(715) 633-4020
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X DR0058490 CO
Otolaryngology Physician 207Y00000X A126898 CA
Pediatric Otolaryngology Physician 207YP0228X DR0058490 CO
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Otolaryngology Physician 207YP0228X A126898 CA Primary

Addresses

Primary practice location

1010 W la Veta Ave Ste 640
Orange, CA 92868-4306

Mailing address

1010 W la Veta Ave Ste 640
Orange, CA 92868-4306
Phone (715) 633-4020

Other practice location 1

5901 E 7th St
VA Long Beach
Long Beach, CA 90822-5201
Phone (562) 826-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180821003952 CA Practitioner - Otolaryngology 7214244987 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A126898CAMDPediatric Otolaryngology Physician
DR0058490COMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Head & Neck Surgeons Otolaryngology CurrentSince Sep 17, 2018 Accepting new patients
Children'S Hospital of Orange County Pediatric Otolaryngology CurrentSince Oct 13, 2018 Accepting new patients
Pediatric Subspecialty Faculty, Inc. Past Accepting new patients
Providence Health & Services - Wa Past Accepting new patients

Locations

1010 W La Veta Ave
Ste 640
Orange, CA 92868
Phone (714) 633-4020

101 The City Dr S
Bldg 25
Orange, CA 92868
Phone (714) 456-5731

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Dept LA 21333
Pasadena, CA 91185

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1174880496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 640",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684306",
            "telephone_number": "715-633-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 640",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684306",
            "telephone_number": "715-633-4020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 E 7th St",
            "address_2": "VA Long Beach",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908225201",
            "country_code": "US",
            "telephone_number": "562-826-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHATT",
        "first_name": "JAY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "DR0058490",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A126898",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "CO",
            "license": "DR0058490",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "CA",
            "license": "A126898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.