Individual provider Active NPI

Moeen Ahmad Bhatti, M.D.

  • Psychiatry Physician
  • Gilroy, CA
National Provider Identifier
1205023736
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A100193 Issued in CA
Practice address
290 100F Ave
Gilroy, CA 95020-5204
Phone
(408) 846-2161
NPI assigned
Sep 28, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A100193 CA Primary

Addresses

Primary practice location

290 100F Ave
Gilroy, CA 95020-5204

Mailing address

290 100F Ave
Gilroy, CA 95020-5204
Phone (408) 846-2161

Other practice location 1

2025 Morse Ave
Sacramento, CA 95825-2115
Phone (916) 973-5300

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
I20071009000584 CA Practitioner - Psychiatry 9830284611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
LGTC GroupGroup PAC ID 0749795102, 22 clinicians

Practice addresses (Care Compare)

4850 Union Ave
San Jose, CA 95124-5156
Phone (800) 913-2615

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100193CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Medical Group Psychiatry CurrentSince Jul 15, 2025 Accepting new patients
LGTC Group Psychiatry CurrentSince Jul 15, 2025 Accepting new patients
Los Gatos Therapy Center PastSince Apr 17, 2022 Accepting new patients

Locations

1575 Old Bayshore Hwy
Ste 201
Burlingame, CA 94010
Phone (408) 542-0399

2542 S Bascom Ave
Ste 100
Campbell, CA 95008
Phone (408) 559-3403

2235 Douglas Blvd
Ste 500
Roseville, CA 95661
Phone (916) 622-2620

508 Gibson Dr
Ste 140
Roseville, CA 95678
Phone (916) 694-0555

4850 Union Ave
San Jose, CA 95124
Phone (408) 559-5600

Organizations & group practices 3

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": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1205023736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 100F AVE",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950205204",
            "telephone_number": "408-846-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 100F AVE",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950205204",
            "telephone_number": "408-846-2161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 Morse Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958252115",
            "country_code": "US",
            "telephone_number": "916-973-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHATTI",
        "first_name": "MOEEN",
        "middle_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A100193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilroy, CA

Sources for this page

Verify at the official NPI Registry.