Organization Active NPI

Southern New Hampshire Internal Medicine Associates, PLLC

  • Specialist
  • Derry, NH
National Provider Identifier
1316026677
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SOUTHERN NEW HAMPSHIRE INTERNAL MEDICINE ASSOCIATES, PLLC
Practice address
6 Tsienneto Rd
Suite 300
Derry, NH 03038-1584
Phone
(603) 216-0400
Fax
(603) 216-3800
NPI assigned
Nov 6, 2006
Last updated
Mar 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Authorized official

Name
Casey Bzdak
Title
Practice Billing Manager
Phone
(603) 216-0479

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

6 Tsienneto Rd
Suite 300
Derry, NH 03038-1584

Mailing address

6 Tsienneto Rd Ste 300
Derry, NH 03038-1584
Phone (603) 216-0400

Other identifiers 1

IdentifierTypeStateIssuer
30211447MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401000153 NH Part B Supplier - Clinic/Group Practice 9133111990 Receives reassigned benefits from 37 practitioners
Practice locations: Bedford, NH; Derry, NH; Windham, NH

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

160 S River Rd
Ste 101A
Bedford, NH 03110
Phone (603) 216-3800

49 Range Rd
#100
Windham, NH 03087

49 Range Rd
Ste 110
Windham, NH 03087

Practitioners & affiliated clinicians

Practitioners 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773964800000",
    "number": "1316026677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD STE 300",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381584",
            "telephone_number": "603-216-0400",
            "fax_number": "603-216-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD",
            "address_2": "SUITE 300",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381584",
            "telephone_number": "603-216-0400",
            "fax_number": "603-216-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN NEW HAMPSHIRE INTERNAL MEDICINE ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A",
        "authorized_official_last_name": "BZDAK",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "PRACTICE BILLING MANAGER",
        "authorized_official_telephone_number": "603-216-0479"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30211447",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.