Individual provider Active NPI

Ahmad K Bayrakdar, M.D.

  • Gastroenterology Physician
  • Worcester, MA
National Provider Identifier
1275647125
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
291590 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655
Phone
(508) 334-3068
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036049153 IL
Gastroenterology Physician 207RG0100X MD60903183 WA
Gastroenterology Physician 207RG0100X MD5712 DC
Gastroenterology Physician 207RG0100X MD433241 PA
Gastroenterology Physician 207RG0100X 01068653A IN
Gastroenterology Physician 207RG0100X 35.142897 OH
Gastroenterology Physician 207RG0100X 291590 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other practice location 1

10600 Montgomery Rd Ste 300
Montgomery, OH 45242-4464
Phone (513) 794-2600

Other practice location 2

157 Union St
Marlborough, MA 01752
Phone (508) 334-3068

Other practice location 3

21 Eastern Ave
Worcester, MA 01605
Phone (508) 856-2500

Other practice location 4

119 Belmont St
Worcester, MA 01605
Phone (508) 334-3068

Other practice location 5

840 E Hill Ave
Moses Lake, WA 98837-2238
Phone (509) 663-8711

Other identifiers 2

IdentifierTypeStateIssuer
000000673602OtherINANTHEM PROVIDER NUMBER
200992410MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 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
I20091210000033 WV Practitioner - Internal Medicine 1850353046
I20210721002922 OH Practitioner - Gastroenterology 1850353046 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Internal Medicine CurrentSince Apr 18, 2023 Accepting new patients
Deaconess Memorial Medical Center Inc Current Accepting new patients
Trihealth G LLC Internal Medicine CurrentSince Jul 19, 2021 Accepting new patients
Uvpc Specialists Inc. CurrentSince Apr 14, 2025 Accepting new patients
The Metrohealth System CurrentSince Apr 18, 2023 Accepting new patients
Trihealth G, LLC CurrentSince Jul 19, 2021 Accepting new patients
Camden-Clark Physician Corporation CurrentSince Dec 1, 2025 Accepting new patients
Uvpc Specialists, Inc. CurrentSince Apr 14, 2025 Accepting new patients
The Metrohealth System Current Accepting new patients
Trihealth H LLC Gastroenterology CurrentSince Nov 1, 2021 Accepting new patients
Ronceverte Physician Group LLC Gastroenterology Past Accepting new patients

Locations

800 W 9th St
Jasper, IN 47546
Phone (812) 482-2345

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

10600 Montgomery Rd
Ste 300
Montgomery, OH 45242
Phone (513) 984-2510

3130 N County Road 25A
Ste 212
Troy, OH 45373
Phone (937) 335-0061

705 Garfield Ave
Ste 360
Parkersburg, WV 26101
Phone (304) 424-2088

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

Interoperability endpoints

  • Direct secure messaging: abayrakdar243872@direct.metrohealth.org

Organizations & group practices 11

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1275647125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01655",
            "telephone_number": "508-334-3068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10600 Montgomery Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "OH",
            "postal_code": "452424464",
            "country_code": "US",
            "telephone_number": "513-794-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "157 Union St",
            "address_purpose": "LOCATION",
            "city": "Marlborough",
            "state": "MA",
            "postal_code": "01752",
            "country_code": "US",
            "telephone_number": "508-334-3068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01605",
            "country_code": "US",
            "telephone_number": "508-856-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01605",
            "country_code": "US",
            "telephone_number": "508-334-3068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 E Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "988372238",
            "country_code": "US",
            "telephone_number": "509-663-8711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAYRAKDAR",
        "first_name": "AHMAD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036049153",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD60903183",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "DC",
            "license": "MD5712",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD433241",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01068653A",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35.142897",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "291590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000673602",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200992410",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "840 E Hill Ave",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988372238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.