Active NPI
Petr Bezdicek, MD
- Pulmonary Disease Physician
- Goshen, NY
National Provider Identifier
1528047057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 223433
- Practice address
- 70 Hatfield LN
Suite 101
Goshen, NY 10924-6734 - Phone
- (845) 294-8888
- Fax
- (845) 294-1669
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 223433 | NY | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 223433 | NY | |
| Pulmonary Disease Physician | 207RP1001X | 223433 | NY | Primary |
Addresses
Primary practice location
70 Hatfield LN
Suite 101
Goshen, NY 10924-6734
Mailing address
PO Box 809
Goshen, NY 10924-0809
Phone (845) 294-8888
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02238360 | Medicaid | NY | |
| 290014566 | Other | NY | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051221000804 | NY | Practitioner - Pulmonary Disease | 4789606450 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Bon Secours Charity Health System Medical Group, P.C.
Practice addresses (Care Compare)
70 Hatfield LN
Goshen, NY 10924-6734
Phone (845) 294-8888
Hospital & facility affiliations
- Americare Certified Special Services, Inc Chha
- St Anthony Community Hospital
- Garnet Health Medical Center
- Bon Secours Community Hospital
- Good Samaritan Hospital of Suffern
- Montefiore St Luke'S Cornwall
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.73 of 100
- Quality
- 87.82
- Promoting interoperability
- 92
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Charity Health System Medical Group, P.C. | Internal Medicine | Current | Accepting new patients |
Locations
70 Hatfield Ln
Goshen, NY 10924
Phone (845) 294-2006
70 Hatfield Ln
Ste 101
Goshen, NY 10924
Phone (845) 294-8888
161 E Main St
Ste 300301
Port Jervis, NY 12771
Phone (845) 856-3812
20 Grand St
Fl 3
Warwick, NY 10990
Phone (845) 987-3901
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
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.
-
- Internal Medicine Physician
- Warwick, NY
- NPI 1487694345
Internal Medicine, NY
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Brooklyn, NY
- NPI 1770513145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209686400000",
"number": "1528047057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 809",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109240809",
"telephone_number": "845-294-8888",
"fax_number": "845-294-1669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 HATFIELD LN",
"address_2": "SUITE 101",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109246734",
"telephone_number": "845-294-8888",
"fax_number": "845-294-1669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEZDICEK",
"first_name": "PETR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2008-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "223433",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NY",
"license": "223433",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "223433",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02238360",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "290014566",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goshen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.
- 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.