Individual provider Active NPI

Douglas Harry Bailyn, M.D.

  • Nephrology Physician
  • New York, NY
National Provider Identifier
1306885470
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
222452 Issued in NY
Practice address
380 2ND Ave
Suite 1002
New York, NY 10010-5615
Phone
(212) 571-3331
Fax
(212) 375-0539
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 222452 NY Primary

Addresses

Primary practice location

380 2ND Ave
Suite 1002
New York, NY 10010-5615

Mailing address

47 Plaza St W
Apt. 11a
Brooklyn, NY 11217-3905
Phone (212) 571-3331

Other identifiers 1

IdentifierTypeStateIssuer
02654117MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050517000415 NY Practitioner - NephrologyPractitioner - Internal Medicine 9739120080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

111 Broadway
RM 504
New York, NY 10006-1982
Phone (212) 571-3331

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas H Bailyn, MD, PC Nephrology CurrentSince May 1, 2006 Accepting new patients

Locations

111 Broadway
Rm 504
New York, NY 10006
Phone (212) 537-5039

380 2nd Ave
Ste 1002
New York, NY 10010
Phone (212) 777-1510

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DAGHAA

Organizations & group practices 1

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 7

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1306885470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 PLAZA ST W",
            "address_2": "APT. 11A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112173905",
            "telephone_number": "212-571-3331",
            "fax_number": "212-375-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 2ND AVE",
            "address_2": "SUITE 1002",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105615",
            "telephone_number": "212-571-3331",
            "fax_number": "212-375-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILYN",
        "first_name": "DOUGLAS",
        "middle_name": "HARRY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "222452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02654117",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.