Active NPI
Anis Bhatty, MD
- Pediatrics Physician
- Elmwood Park, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MA40211
- Practice address
- 1 Broadway
Suite 303
Elmwood Park, NJ 07407-1842 - Phone
- (201) 794-8855
- Fax
- (201) 794-6988
- NPI assigned
- Jul 10, 2006
- Last updated
- Mar 31, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA40211 | NJ | Primary |
Addresses
Primary practice location
1 Broadway
Suite 303
Elmwood Park, NJ 07407-1842
Mailing address
1 Broadway
Suite 303
Elmwood Park, NJ 07407-1842
Phone (201) 794-8855
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0984697004 | Other | NJ | CIGNA |
| 510452 | Other | NJ | UNITED HEALTHCARE |
| 4197029 | Other | NJ | AETNA |
| OK2765 | Other | NJ | HEALTHNET |
| 1028441 | Other | NJ | HORIZON MERCY |
| 10832 | Other | NJ | AMERIGROUP |
| 317521 | Other | NJ | EMPIRE |
| PP071 | Other | NJ | OXFORD |
| 01000452700 | Other | NJ | AMERICHOICE |
| 184090801 | Medicaid | NJ | |
| J5146 | Other | NJ | HORIZON |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA40211 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Medical Care of New Jersey PC | Current | Accepting new patients | |
| Optum Medical Care of New Jersey PC | Pediatrics | Current | Accepting new patients |
| A.G. Dikengil, MD, PA | Past | Accepting new patients |
Locations
935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012
38 Meadowlands Pkwy
Ste 205
Secaucus, NJ 07094
Phone (201) 552-2357
3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974
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.
-
dba Riverside Medical Group
- Durable Medical Equipment & Medical Supplies
- Belleville, NJ
- NPI 1255050902
-
- Radiology Clinic/Center
- Lyndhurst, NJ
- NPI 1205992690
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427760000000",
"number": "1285668871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BROADWAY",
"address_2": "SUITE 303",
"city": "ELMWOOD PARK",
"state": "NJ",
"postal_code": "074071842",
"telephone_number": "201-794-8855",
"fax_number": "201-794-6988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BROADWAY",
"address_2": "SUITE 303",
"city": "ELMWOOD PARK",
"state": "NJ",
"postal_code": "074071842",
"telephone_number": "201-794-8855",
"fax_number": "201-794-6988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHATTY",
"first_name": "ANIS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2015-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MA40211",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0984697004",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "510452",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4197029",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "OK2765",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON MERCY",
"identifier": "1028441",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10832",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE",
"identifier": "317521",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "PP071",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE",
"identifier": "01000452700",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184090801",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON",
"identifier": "J5146",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elmwood Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.