Individual provider Active NPI

Jasmin F Bhathena, MD

  • Pediatrics Physician
  • Peabody, MA
National Provider Identifier
1386626299
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
82921 Issued in MA
Practice address
2 Essex Center Dr
Peabody, MA 01960-2926
Phone
(978) 977-4300
Fax
(978) 977-4313
NPI assigned
Nov 16, 2005
Last updated
Jan 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 82921 MA Primary

Addresses

Primary practice location

2 Essex Center Dr
Peabody, MA 01960-2926

Mailing address

2 Essex Center Dr
Peabody, MA 01960-2926
Phone (978) 977-4300

Other identifiers 2

IdentifierTypeStateIssuer
J19587OtherMABLUE CROSS BLUE SHIEL
3191729MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbhathenamd21626@direct.atrius.masshiway.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20090708000702 MA Practitioner - Pediatric Medicine 4284786005 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82921MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Nov 28, 2010 Accepting new patients
Atrius Health, Inc. Pediatrics CurrentSince Nov 28, 2010 Accepting new patients
Atrius Health, Inc. Pediatrics Past Accepting new patients

Locations

77 Herrick St
Ste 101
Beverly, MA 01915
Phone (978) 232-7115

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Boston, MA 02109
Phone (617) 421-2508

2 Essex Dr
Peabody, MA 01960
Phone (978) 977-4000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1386626299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ESSEX CENTER DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602926",
            "telephone_number": "978-977-4300",
            "fax_number": "978-977-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ESSEX CENTER DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602926",
            "telephone_number": "978-977-4300",
            "fax_number": "978-977-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATHENA",
        "first_name": "JASMIN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "82921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIEL",
            "identifier": "J19587",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3191729",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbhathenamd21626@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "2 Essex Center Dr",
            "city": "Peabody",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019602926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.