Individual provider Active NPI

Bushra Iftikhar, MD

  • Psychiatry Physician
  • Troy, NY
National Provider Identifier
1376941757
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
281827 Issued in NY
Practice address
2215 Burdett Ave
Troy, NY 12180
Phone
(518) 270-3008
NPI assigned
Dec 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 281827 NY Primary

Addresses

Primary practice location

2215 Burdett Ave
Troy, NY 12180

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

3 Mercycare Ln
Guilderland, NY 12084-3504
Phone (518) 452-6700

Other practice location 2

315 S Manning Blvd Ste 6408A
Albany, NY 12208-1707
Phone (518) 525-1303

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20161101000124 NY Practitioner - Psychiatry 9830477512 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany Psychiatry CurrentSince Sep 9, 2019 Accepting new patients
Samaritan Hospital of Troy, New York Psychiatry CurrentSince Sep 26, 2016 Accepting new patients
St. Peter'S Hospital of the City of Albany Psychiatry CurrentSince Sep 9, 2019 Accepting new patients

Locations

315 S Manning Blvd
Ste 6408A
Albany, NY 12208
Phone (518) 525-1301

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

3 Mercycare Ln
Guilderland, NY 12084
Phone (518) 452-6700

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1376941757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "12180",
            "telephone_number": "518-270-3008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Mercycare Ln",
            "address_purpose": "LOCATION",
            "city": "Guilderland",
            "state": "NY",
            "postal_code": "120843504",
            "country_code": "US",
            "telephone_number": "518-452-6700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Manning Blvd Ste 6408A",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IFTIKHAR",
        "first_name": "BUSHRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "281827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd Ste 6408A",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.