Individual provider Active NPI

Gaiti Ara Bakhsh, D.O.

  • Emergency Medicine Physician
  • Taylor, MI
National Provider Identifier
1245286509
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101011604 Issued in MI
Practice address
10000 Telegraph Road,
Emergency Medicine Department
Taylor, MI 48180-3330
Phone
(313) 295-5007
Fax
(313) 295-6725
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101011604 MI Primary
Emergency Medicine Physician 207P00000X 0102203148 VA
Emergency Medicine Physician 207P00000X OS016514 PA

Addresses

Primary practice location

10000 Telegraph Road,
Emergency Medicine Department
Taylor, MI 48180-3330

Mailing address

38935 Ann Arbor Road
Credentialing/Payer Contracting Services
Livonia, MI 48150-3397
Phone (734) 632-0175

Other identifiers 1

IdentifierTypeStateIssuer
11271278OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040628000834 MI Practitioner - Emergency Medicine 9537145776 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS016514PAMDEmergency Medicine Physician
0102203148VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Michigan, P.C. Emergency Medicine CurrentSince May 1, 2014 Accepting new patients
Statcare PC Emergency Medicine Past Accepting new patients
Professional Emergency Care, PC Emergency Medicine Past Accepting new patients
Stat Care PC Past Accepting new patients

Locations

7300 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1245286509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR ROAD",
            "address_2": "CREDENTIALING/PAYER CONTRACTING SERVICES",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503397",
            "telephone_number": "734-632-0175",
            "fax_number": "734-632-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 TELEGRAPH ROAD,",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803330",
            "telephone_number": "313-295-5007",
            "fax_number": "313-295-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKHSH",
        "first_name": "GAITI",
        "middle_name": "ARA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101011604",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102203148",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS016514",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11271278",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.