Individual provider Active NPI

Fattollah Nejat-Bakhsh, DC

  • Chiropractor
  • San Antonio, TX
National Provider Identifier
1477645364
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9120 Issued in TX
Practice address
603 Isom Rd
Ste # 103
San Antonio, TX 78216-4455
Phone
(210) 340-0333
Fax
(210) 340-0955
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9120 TX Primary

Addresses

Primary practice location

603 Isom Rd
Ste # 103
San Antonio, TX 78216-4455

Mailing address

603 Isom Rd
Ste # 103
San Antonio, TX 78216-4455
Phone (210) 340-0333

Other identifiers 5

IdentifierTypeStateIssuer
7067472OtherAETNA
4370625OtherTXCIGNA
656439OtherTXACN
606413OtherBCBS
155508801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050303000479 TX Practitioner - Chiropractic 5294789103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

603 Isom Rd
Suite 103
San Antonio, TX 78216-4454
Phone (210) 340-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bakhsh Chiropractic Clinic Inc. Chiropractor CurrentSince Oct 1, 2007 Accepting new patients

Locations

603 Isom Rd
Ste 103
San Antonio, TX 78216
Phone (210) 340-0333

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1477645364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 ISOM RD",
            "address_2": "STE # 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782164455",
            "telephone_number": "210-340-0333",
            "fax_number": "210-340-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 ISOM RD",
            "address_2": "STE # 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782164455",
            "telephone_number": "210-340-0333",
            "fax_number": "210-340-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEJAT-BAKHSH",
        "first_name": "FATTOLLAH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7067472",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4370625",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "656439",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "606413",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155508801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.