Individual provider Active NPI

Bahar Hadjiesmaeiloo, M.D.

  • Psychiatry Physician
  • Bryn Mawr, PA
National Provider Identifier
1548585292
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA09704000 Issued in NJ
Practice address
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone
(484) 337-4286
Fax
(484) 337-4293
NPI assigned
Apr 6, 2010
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD452306 PA
Psychiatry Physician 2084P0800X 25MA09704000 NJ Primary

Addresses

Primary practice location

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

Mailing address

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-4286

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150723008674 NJ Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 2163649716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
George Washington University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Creative Care Psychiatry LLCGroup PAC ID 8022595008, 5 clinicians

Practice addresses (Care Compare)

1 Marine PLZ
Suite 307
North Bergen, NJ 07047-6234
Phone (201) 429-5773

221 Park Ave
Rutherford, NJ 07070-2309
Phone (201) 293-0976

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD452306PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Care Psychiatry LLC Psychiatry CurrentSince Dec 13, 2025 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Aug 1, 2016 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Aug 1, 2016 Accepting new patients
Creative Care Psychiatry, PLLC Psychiatry Current Accepting new patients
Creative Care Psychiatry Psychiatry CurrentSince Dec 14, 2025 Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

1111 Hudson St
Hoboken, NJ 07030
Phone (201) 942-9314

1 Marine Plz
Ste 307
North Bergen, NJ 07047
Phone (201) 429-5773

221 Park Ave
Rutherford, NJ 07070
Phone (201) 293-0976

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Interoperability endpoints

  • Direct secure messaging: bhadjiesmaeiloo75588@direct.optum.com
  • FHIR API: https://api.platform.athenahealth.com/22818/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1548585292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-4286",
            "fax_number": "484-337-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-4286",
            "fax_number": "484-337-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADJIESMAEILOO",
        "first_name": "BAHAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD452306",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA09704000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.