Active NPI
Bismah Irfan, MD
- Nephrology Physician
- Bronx, NY
National Provider Identifier
1457604324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 288212
- Practice address
- 4256 Bronx Blvd Ste 3
Bronx, NY 10466-2672 - Phone
- (718) 690-3666
- Fax
- (855) 816-0750
- NPI assigned
- Oct 17, 2012
- Last updated
- Jan 18, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125062109 | IL | |
| Nephrology Physician | 207RN0300X | 288212 | NY | Primary |
Addresses
Primary practice location
4256 Bronx Blvd Ste 3
Bronx, NY 10466-2672
Mailing address
4256 Bronx Blvd Ste 3
Bronx, NY 10466-2672
Phone (718) 690-3666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125062109 | IL | MD | Internal Medicine Physician |
| 288212 | NY | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ydr Geriatrics & Nephrology LLP | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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": "1350432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516233600000",
"number": "1457604324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4256 BRONX BLVD STE 3",
"city": "BRONX",
"state": "NY",
"postal_code": "104662672",
"telephone_number": "718-690-3666",
"fax_number": "855-816-0750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4256 BRONX BLVD STE 3",
"city": "BRONX",
"state": "NY",
"postal_code": "104662672",
"telephone_number": "718-690-3666",
"fax_number": "855-816-0750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRFAN",
"first_name": "BISMAH",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-17",
"last_updated": "2018-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125062109",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NY",
"license": "288212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.