Individual provider Active NPI

Bibhuti B Mishra, MD

  • Neurology Physician
  • McLean, VA
National Provider Identifier
1215973540
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101047021 Issued in VA
Practice address
6845 Elm St Ste 700
MC Lean, VA 22101-3851
Phone
(703) 356-1105
Fax
(703) 356-0970
NPI assigned
Jun 22, 2006
Last updated
Dec 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0101047021 VA Primary

Addresses

Primary practice location

6845 Elm St Ste 700
MC Lean, VA 22101-3851

Mailing address

PO Box 791093
Baltimore, MD 21279-1093

Other identifiers 1

IdentifierTypeStateIssuer
007101741MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20181115001671 NY Practitioner - Neurology 5092603779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Sep 25, 2018 Accepting new patients
Northwell Health Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

611 Northern Blvd
Ste 150
Great Neck, NY 11021
Phone (516) 325-7000

300 Community Dr
Manhasset, NY 11030

300 Community Dr
Fl 1
Manhasset, NY 11030
Phone (516) 562-2252

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: bibhutimishra@northwell.allscriptsdirect.net

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1215973540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791093",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6845 ELM ST STE 700",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013851",
            "telephone_number": "703-356-1105",
            "fax_number": "703-356-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "BIBHUTI",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101047021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007101741",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

Verify at the official NPI Registry.