Individual provider Active NPI

Tejalben H Bakhtiani

  • Family Nurse Practitioner
  • Newburgh, IN
National Provider Identifier
1417316852
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011821A Issued in IN
Practice address
100 St Marys Epworth Xing Ste B100
Newburgh, IN 47630-9497
Phone
(812) 853-9651
NPI assigned
Feb 13, 2016
Last updated
May 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704324918 MI
Family Nurse Practitioner 363LF0000X 71011821A IN Primary

Addresses

Primary practice location

100 St Marys Epworth Xing Ste B100
Newburgh, IN 47630-9497

Mailing address

100 St Marys Epworth Xing Ste B100
Newburgh, IN 47630-9497

Other practice location 1

801 Saint Marys Dr
Evansville, IN 47714-0511
Phone (812) 485-5388

Other identifiers 1

IdentifierTypeStateIssuer
F0516969OtherMIAANP NUMBER

Other names 1

  • Tejal Patel Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tejal.bakhtiani.2@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211130000923 IN Practitioner - Nurse Practitioner 6507143633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

100 St Marys Epworth Xing
Suite B100
Newburgh, IN 47630-9161
Phone (812) 853-9651

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71011821AINMDFamily Nurse Practitioner
4704324918MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Medical Group, LLC Family CurrentSince Dec 13, 2021 Accepting new patients
St Mary's Medical Group, LLC CurrentSince Dec 13, 2021 Accepting new patients
St. Mary's Health, Inc Past Accepting new patients

Locations

100 S Rosenberger Ave
Ste A100
Evansville, IN 47712
Phone (812) 433-2000

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

100 St Marys Epworth Xing
Ste B100
Newburgh, IN 47630
Phone (812) 469-8300

Interoperability endpoints

  • Direct secure messaging: tejal.bakhtiani.2@7598.direct.athenahealth.com
  • Direct secure messaging: tejalben.bakhtiani.1@7598.direct.athenahealth.com
  • Direct secure messaging: tejalben.bakhtiani.2@7598.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1455321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1417316852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ST MARYS EPWORTH XING STE B100",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ST MARYS EPWORTH XING STE B100",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309497",
            "telephone_number": "812-853-9651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Saint Marys Dr",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140511",
            "country_code": "US",
            "telephone_number": "812-485-5388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKHTIANI",
        "first_name": "TEJALBEN",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-13",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704324918",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011821A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP NUMBER",
            "identifier": "F0516969",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tejal.bakhtiani.2@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "100 St Marys Epworth Xing Ste B100",
            "city": "Newburgh",
            "state": "IN",
            "country_code": "US",
            "postal_code": "476309497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TEJAL",
            "last_name": "PATEL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.