Individual provider Active NPI

Bishaswar Mahadeo, PHARM. D.

  • Pharmacist
  • Bunnell, FL
National Provider Identifier
1558775205
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS42466 Issued in FL
Practice address
4750 E Moody Blvd
Unit 107
Bunnell, FL 32110-7709
Phone
(386) 597-1082
NPI assigned
Jun 19, 2014
Last updated
Jun 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS42466 FL Primary

Addresses

Primary practice location

4750 E Moody Blvd
Unit 107
Bunnell, FL 32110-7709

Mailing address

4750 E Moody Blvd
Unit 107
Bunnell, FL 32110-7709

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS42466FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
A & B Pharmaceutical Services Inc 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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1558775205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 E MOODY BLVD",
            "address_2": "UNIT 107",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321107709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 E MOODY BLVD",
            "address_2": "UNIT 107",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321107709",
            "telephone_number": "386-597-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHADEO",
        "first_name": "BISHASWAR",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS42466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bunnell, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.