Bashyam Iyengar, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME110643 Issued in FL

Practice address

1760 Edgewood Ave W Ste B
Suite B
Jacksonville, FL 32208-7209

Phone

(904) 358-8480

Fax

(904) 358-8460

NPI assigned

Nov 4, 2010

Last updated

May 22, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincents Medical Center IncGroup PAC ID 0244144558, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's Riverside Hospital, Jacksonville, FL, CCN 100040

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bashyam.iyengar.2@8967.direct.athenahealth.com

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.

• St Vincents Medical Center Inc

  dba St Vincents Family Medicine Center

  • Primary Care Clinic/Center
  • Jacksonville, FL
  • NPI 1427005131
  Medicare reassignment Care Compare group NPD
• St Vincents Medical Center Inc

  dba Ascension St. Vincent's Riverside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Vincents Medical Center Inc

  dba Ascension St. Vincent's Riverside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  Care Compare affiliation
• St. Vincent's Medical Center, Inc.

  dba Ascension St Vincent's Riverside

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1205137403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 EDGEWOOD AVE W STE B",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322087209",
            "telephone_number": "904-358-8480",
            "fax_number": "904-358-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 EDGEWOOD AVE W STE B",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322087209",
            "telephone_number": "904-358-8480",
            "fax_number": "904-358-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYENGAR",
        "first_name": "BASHYAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-04",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME110643",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08303600",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "255281-1",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60189759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Ivory
• Ivps of Jacksonsonville
• Jeremy David Ivy
• Nadia Iwanyshyn
• Amanda Iway, OTR
• Shreya Iyengar
• Olatunbosun Modupe Iyewarun, P.T.
• Catherine E Iyoha-Idiong, MB CHB
• Walter John Izarra
• Lauren Izquierdo

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.