NPIMap

Organization Active NPI

Visavis Health Care Medical Group of WV PLLC

  • Family Medicine Physician
  • Hurricane, WV
National Provider Identifier
1215792155
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VISAVIS HEALTH CARE MEDICAL GROUP OF WV PLLC
Practice address
1390 N Poplar Fork Rd
Hurricane, WV 25526-7112
Phone
(929) 491-7333
NPI assigned
Feb 20, 2024
Last updated
May 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Authorized official

Name
Rekha BhandariNPI 1023035466
Title
Owner
Phone
(212) 734-6621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1390 N Poplar Fork Rd
Hurricane, WV 25526-7112

Mailing address

831 Bedford Ave Ste 530
Brooklyn, NY 11205-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240425002017 WV Part B Supplier - Clinic/Group Practice 8224478136 Receives reassigned benefits from 27 practitioners
Practice locations: Hurricane, WV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1215792155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 BEDFORD AVE STE 530",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 N POPLAR FORK RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255267112",
            "telephone_number": "929-491-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISAVIS HEALTH CARE MEDICAL GROUP OF WV PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "BHANDARI",
        "authorized_official_first_name": "REKHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-734-6621"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.