Individual provider Active NPI

Gauri K Bhardwaj, M.D.

  • Specialist
  • Johnson City, NY
National Provider Identifier
1366476657
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1293791 Issued in NY
Practice address
699 Main St
Johnson City, NY 13790-1743
Phone
(607) 770-0004
Fax
(607) 770-0851
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1293791 NY Primary

Addresses

Primary practice location

699 Main St
Johnson City, NY 13790-1743

Mailing address

699 Main St
Johnson City, NY 13790-1743
Phone (607) 770-0004

Other identifiers 1

IdentifierTypeStateIssuer
00614282MedicaidNY

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
I20110826000089 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Geriatric Medicine 0840460077 Practice locations: Johnson City, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1293791NYMDSpecialist

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Geriatric Medicine, Internal Medicine
Education
Other, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

699 Main St
Johnson City, NY 13790-1743
Phone (607) 770-0004

699 Main St
Johnson City, NY 13790-1796

Hospital & facility affiliations

  • Our Lady of Lourdes Memorial Hospital, Inc Hospital, Binghamton, NY, CCN 330011
  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

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": "1331164800000",
    "number": "1366476657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 MAIN ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901743",
            "telephone_number": "607-770-0004",
            "fax_number": "607-770-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 MAIN ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901743",
            "telephone_number": "607-770-0004",
            "fax_number": "607-770-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHARDWAJ",
        "first_name": "GAURI",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1293791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00614282",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.