Kalyan K Bachu, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME107952 Issued in FL

Practice address

2180 W State Road 434
Suite 2110
Longwood, FL 32779-5041

Phone

(347) 853-4719

NPI assigned

Jun 24, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1497916183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 W STATE ROAD 434",
            "address_2": "SUITE 2110",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795041",
            "telephone_number": "347-853-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 W STATE ROAD 434",
            "address_2": "SUITE 2110",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795041",
            "telephone_number": "347-853-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHU",
        "first_name": "KALYAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME107952",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "258972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jannelys Aviles Aguilar, MD
• Azelvandre DO and Associates LLC
• Jacqueline Azelvandre, D.O.
• Caitlyn Aznar
• Babble Babble and Beyond
• Yurien Baez Grillo
• Brooke Elizabeth Bailey
• Alison Nicole Baker
• Santashia Baker
• Antoinette Baldwin

• Internal Medicine Physician in Longwood, FL
• Providers in Longwood, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.