Individual provider Active NPI

Maninder Singh Bhutani, M.D.

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1265876833
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A143230 Issued in CA
Practice address
450 Clarkson Ave
Box 1262
Brooklyn, NY 11203-2012
Phone
(718) 270-8867
NPI assigned
Apr 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD047518 DC
Psychiatry Physician 2084P0800X 0101267136 VA
Psychiatry Physician 2084P0800X A143230 CA Primary

Addresses

Primary practice location

450 Clarkson Ave
Box 1262
Brooklyn, NY 11203-2012

Mailing address

450 Clarkson Ave
Box 1262
Brooklyn, NY 11203-2012

Other practice location 1

24077 State Highway 49
Nevada City, CA 95959-8519
Phone (530) 265-9057

Other practice location 2

1200 Sam Perry Blvd
Fredericksburg, VA 22401-4456
Phone (540) 741-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200108001323 DC Practitioner - Psychiatry 6204261803 Reassigns benefits to 1 organization
I20231204003197 VA Practitioner - Psychiatry 6204261803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Nebraska College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 Sam Perry Blvd
Fredericksburg, VA 22401-4456
Phone (540) 741-3900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143230CAMDPsychiatry Physician
MD047518DCMDPsychiatry Physician
0101267136VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Oct 7, 2023 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Oct 7, 2023 Accepting new patients
Wisconsin Ave Psychiatric Center Inc Psychiatry CurrentSince Nov 17, 2019 Accepting new patients
Ironwood Mind Center PLLC Psychiatry Current Accepting new patients

Locations

4228 Wisconsin Ave NW
Washington, DC 20016
Phone (202) 885-5600

1200 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 372-3900

621 Emancipation Hwy
Ste 201
Fredericksburg, VA 22401
Phone (540) 372-2028

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

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.

Hospital & facility affiliations 4

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": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1265876833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-8867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24077 State Highway 49",
            "address_purpose": "LOCATION",
            "city": "Nevada City",
            "state": "CA",
            "postal_code": "959598519",
            "country_code": "US",
            "telephone_number": "530-265-9057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Sam Perry Blvd",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014456",
            "country_code": "US",
            "telephone_number": "540-741-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHUTANI",
        "first_name": "MANINDER",
        "middle_name": "SINGH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-25",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD047518",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101267136",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A143230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.