Individual provider Active NPI

Debra Lynne Bavari, M.D.

  • Family Medicine Physician
  • Frederick, MD
National Provider Identifier
1184600876
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD065028-L Issued in PA
Practice address
1434 Porter St
Barquist Army Health Clinic
Frederick, MD 21702-9210
Phone
(301) 619-7175
Fax
(301) 619-7676
NPI assigned
Dec 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD065028-L PA Primary

Addresses

Primary practice location

1434 Porter St
Barquist Army Health Clinic
Frederick, MD 21702-9210

Mailing address

1434 Porter St
Barquist Army Health Clinic
Frederick, MD 21702-9210
Phone (301) 619-7175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110408000394 MD Order and Referring Only - Family PracticePractitioner - Family Practice 0941483820

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD065028-LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1184600876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 PORTER ST",
            "address_2": "BARQUIST ARMY HEALTH CLINIC",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217029210",
            "telephone_number": "301-619-7175",
            "fax_number": "301-619-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 PORTER ST",
            "address_2": "BARQUIST ARMY HEALTH CLINIC",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217029210",
            "telephone_number": "301-619-7175",
            "fax_number": "301-619-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAVARI",
        "first_name": "DEBRA",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD065028-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.