Individual provider Active NPI

Manisha K. Bulsara, PA-C

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1306015714
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
011671 Issued in NY
Practice address
45 Main St
Suite 175
Brooklyn, NY 11201-1000
Phone
(347) 328-0300
NPI assigned
Feb 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 011671 NY Primary

Addresses

Primary practice location

45 Main St
Suite 175
Brooklyn, NY 11201-1000

Mailing address

4545 E Shea Blvd
Suite 175
Phoenix, AZ 85028-3074
Phone (602) 317-6874

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
I20080509000464 NY Practitioner - Physician Assistant 1153400510 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Physician Services, PC PastSince Mar 10, 2009 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8825/brand/4/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1306015714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 E SHEA BLVD",
            "address_2": "SUITE 175",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283074",
            "telephone_number": "602-317-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MAIN ST",
            "address_2": "SUITE 175",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011000",
            "telephone_number": "347-328-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULSARA",
        "first_name": "MANISHA",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.