NPIMap

Individual provider Active NPI

Jennifer Ann-Nicole Bhavsar, M.D.

  • Family Medicine Physician
  • College Station, TX
National Provider Identifier
1457513103
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P4422 Issued in TX
Practice address
4421 State Highway 6 S Ste 100
College Station, TX 77845-6176
Phone
(979) 690-4828
Fax
(979) 690-4829
NPI assigned
Jun 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31012 SC
Family Medicine Physician 207Q00000X P4422 TX Primary

Addresses

Primary practice location

4421 State Highway 6 S Ste 100
College Station, TX 77845-6176

Mailing address

4421 State Highway 6 S Ste 100
College Station, TX 77845-6176
Phone (979) 690-4828

Other identifiers 1

IdentifierTypeStateIssuer
307554102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121023000153 TX Practitioner - Family Practice 1951571629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health Center 141 clinicians

Practice addresses (Care Compare)

4421 State Hwy 6 S
Suite 100
College Station, TX 77845-6176
Phone (979) 690-4460

Hospital & facility affiliations

  • CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31012SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Regional Health Center CurrentSince Dec 1, 2012 Accepting new patients
St. Joseph Regional Health Center Family Medicine CurrentSince Dec 1, 2012 Accepting new patients
Jonathan a. Friedman, M.D., PLLC Past Accepting new patients
College Station Hospital LP Past Accepting new patients
Coastal Carolina Primary Care, LLC Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

2800 S Texas Ave
Ste 202
Bryan, TX 77802
Phone (979) 774-2060

4421 State Highway 6 S
College Station, TX 77845
Phone (979) 690-4260

4421 State Highway 6 S
Ste 100
College Station, TX 77845
Phone (979) 731-5200

Interoperability endpoints

  • Direct secure messaging: jennifer.bhavsar@sjrhc.eclinicaldirectplus.com

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1457513103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 STATE HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-690-4828",
            "fax_number": "979-690-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 STATE HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-690-4828",
            "fax_number": "979-690-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAVSAR",
        "first_name": "JENNIFER",
        "middle_name": "ANN-NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "31012",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P4422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307554102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.