Individual provider Active NPI

Mohammad Parvez Bhidya, MD

  • Nephrology Physician
  • Jamaica, NY
National Provider Identifier
1407871007
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD0000025564 Issued in TN
Practice address
VA New York Harbor Healthcare System
179-00 Linden Blvd
Jamaica, NY 11425-0001
Phone
(718) 526-1000
Fax
(718) 526-1000
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD0000025564 TN Primary

Addresses

Primary practice location

VA New York Harbor Healthcare System
179-00 Linden Blvd
Jamaica, NY 11425-0001

Mailing address

VA New York Harbor Healthcare System
179-00 Linden Blvd
Jamaica, NY 11425
Phone (718) 526-1000

Other identifiers 2

IdentifierTypeStateIssuer
3370042MedicaidTN
3378072MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20120117000722 TN Practitioner - Internal Medicine 7618873043 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000025564TNMDNephrology Physician
25564TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Sep 10, 2017 Accepting new patients
Southeastern Physician Services PC CurrentSince Jan 1, 2015 Accepting new patients
App of Tennessee HM, PLLC CurrentSince Sep 1, 2019 Accepting new patients
Summit Medical Group, PLLC CurrentSince Sep 10, 2017 Accepting new patients

Locations

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

106 Medical Center Blvd
Fayetteville, TN 37334
Phone (931) 438-1100

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

10820 Parkside Dr
Knoxville, TN 37934
Phone (865) 218-7011

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 4

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1407871007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VA NEW YORK HARBOR HEALTHCARE SYSTEM",
            "address_2": "179-00 LINDEN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11425",
            "telephone_number": "718-526-1000",
            "fax_number": "718-526-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA NEW YORK HARBOR HEALTHCARE SYSTEM",
            "address_2": "179-00 LINDEN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114250001",
            "telephone_number": "718-526-1000",
            "fax_number": "718-526-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHIDYA",
        "first_name": "MOHAMMAD",
        "middle_name": "PARVEZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "MD0000025564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3370042",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3378072",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.