Individual provider Active NPI

Zeena Aleeza Bacchus, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1255805206
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F343916 Issued in NY
Practice address
1065 Southern Blvd
Bronx, NY 10459-2417
Phone
(718) 589-2440
NPI assigned
Jan 13, 2019
Last updated
May 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F343916 NY Primary

Addresses

Primary practice location

1065 Southern Blvd
Bronx, NY 10459-2417

Mailing address

1065 Southern Blvd
Bronx, NY 10459-2417

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190418001932 NY Practitioner - Nurse Practitioner 1153662242 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urban Health Plan IncGroup PAC ID 3173517281, 158 clinicians

Practice addresses (Care Compare)

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F343916NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Urban Health Plan, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Matrix Medical of New York PC CurrentSince Jun 1, 2022 Accepting new patients
Urban Health Plan, Inc. Current Accepting new patients

Locations

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

1515 Southern Blvd
Bronx, NY 10460
Phone (718) 589-1600

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

1967 Turnbull Ave
Bronx, NY 10473
Phone (718) 684-1320

271 E 138th St
Bronx, NY 10454
Phone (347) 407-7120

3209 3rd Ave
Bronx, NY 10451
Phone (347) 284-0203

866 E Tremont Ave
Bronx, NY 10460
Phone (347) 284-0595

890 Hunts Point Ave
Bronx, NY 10474
Phone (718) 589-2141

960 Southern Blvd
Bronx, NY 10459
Phone (347) 331-6572

3712 108th St
Corona, NY 11368
Phone (718) 639-4107

4510 94th St
Elmhurst, NY 11373
Phone (347) 748-6115

154 W 127th St
New York, NY 10027
Phone (212) 280-0804

1740 Broadway
Fl 15
New York, NY 10019
Phone (201) 256-5032

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Networks

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

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, 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": "1547337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1255805206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCHUS",
        "first_name": "ZEENA",
        "middle_name": "ALEEZA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-13",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F343916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.