Omid Bakhtar, D.O.
Individual provider Active NPI Internal Medicine Physician · Watsonville, CA
NPI 1194953901 · NPPES record last updated Apr 4, 2019
Key facts
- NPI
- 1194953901
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 5101018220 (MI)
- Practice address
- 65 Neilson St Ste 102
Watsonville, CA 95076-2491 - Phone
- (831) 768-6217
- Fax
- (831) 768-6219
- NPI assigned
- Jun 30, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Pajaro Valley Health Care District
Practice addresses (Care Compare)
65 Neilson St
Watsonville, CA 95076-2491
Hospital & facility affiliations
- SRS-Watsonville Dialysis, LLC
- SHC Watsonville
- Watsonville Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.92 of 100
- Quality
- 76.62
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.32
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.67 of 100
- Quality
- 81.56
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 67.22
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140904002018 | CA | Practitioner - Internal Medicine |
7416175492 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101018220 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pajaro Valley Health Care District | Internal Medicine | Current |
Accepting new patients |
| Coastal Health Partners | Current |
Accepting new patients | |
| Pajaro Valley Health Care District Hospital Corporation | Past | Accepting new patients | |
| Watsonville Hospital Corporation | Past | Accepting new patients |
Locations
65 Nielson St
Ste 102
Watsonville, CA 95076
Phone (831) 763-6487
65 Nielson St
Ste 125
Watsonville, CA 95076
Phone (831) 768-6266
75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741
Interoperability endpoints
- omid.bakhtar.2@7346.direct.athenahealth.com
- https://api.platform.athenahealth.com/7346/brand/1/csg/1/fhir/r4
- obakhtar@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 5101018220 | MI | Yes |
Addresses
Primary practice location
65 Neilson St Ste 102
Watsonville, CA 95076-2491
Mailing address
3035 Duvall CT
Gilroy, CA 95020-9165
Phone (517) 604-0274
Other practice location 1
6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-0515
Other providers in Watsonville, CA
- Analise Avila
- Lena Axelsson
- Mayra Ayala
- Arbin Aquino Bagamaspad
- Thomas Michael Baglin
- Cesar Baltazar
- Barbara Jean Bannan
- Gilbert David Bao
- Deborah Barber
- Lourdes Hernandez Barraza
All providers in Watsonville, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.