Individual provider Active NPI

Paryush Lakhtaria, M. D.

  • Surgery Physician
  • Staten Island, NY
National Provider Identifier
1336383603
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
279288 Issued in NY
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(914) 216-4564
NPI assigned
Apr 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 279288 NY Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

20 Grand Street, 3Rd FL
Warwick, NY 10990-1035
Phone (845) 987-3901

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
I20160803000599 NY Practitioner - General Surgery 9537453220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Charity Health System Medical Group, P.C.Group PAC ID 1658262084, 157 clinicians

Practice addresses (Care Compare)

257 Lafayette Ave
Suffern, NY 10901-4830
Phone 845353560025027

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as apm
Quality
87.82
Promoting interoperability
92
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)16
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279288NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Charity Health System Medical Group, P.C. Surgery CurrentSince Aug 1, 2016 Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients

Locations

60 Dutch Hill Rd
Orangeburg, NY 10962
Phone (845) 359-4770

10 Liberty Square Mall
Stony Point, NY 10980
Phone (845) 369-8800

257 Lafayette Ave
Ste 200
Suffern, NY 10901
Phone (845) 369-8800

20 Grand St
Fl 3
Warwick, NY 10990
Phone (845) 987-3901

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

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 3

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": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1336383603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND STREET, 3RD FL",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-987-3901",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "914-216-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKHTARIA",
        "first_name": "PARYUSH",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "279288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.