Bethpage Medical Wellness PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

221358 Issued in NY

Legal business name

BETHPAGE MEDICAL WELLNESS PC

Practice address

4250 Hempstead Tpke
Suite 19
Bethpage, NY 11714-5711

Phone

(516) 597-4433

NPI assigned

Sep 14, 2012

Last updated

Jun 27, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bita Ashourzadeh, MDNPI 1790720027

Title

Owner

Phone

(516) 610-5081

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bita Ashourzadeh, MD

  • Internal Medicine Physician
  • Great Neck, NY
  • NPI 1790720027
  Medicare reassignment NPD Authorized official
• Kourosh Ashourzadeh, DO

  • Pediatrics Physician
  • Levittown, NY
  • NPI 1386826675
  NPD (past)

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1578813838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 HEMSTEAD TURNPIKE",
            "address_2": "SUITE 19",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145707",
            "telephone_number": "516-597-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 HEMPSTEAD TPKE",
            "address_2": "SUITE 19",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145711",
            "telephone_number": "516-597-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHPAGE MEDICAL WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-14",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "ASHOURZADEH",
        "authorized_official_first_name": "BITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-610-5081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02227989",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethpage Adolescent Development Association Inc (People Counseling)
• Bethpage Fire District
• Bethpage Magnetic Resonance Imaging, P.C.
• Bethpage Magnetic Resonance Imaging, PC (Bethpage Open MRI)
• Bethpage Medical Practice PLLC
• Bethpage OB/GYN, P.C.
• Bethpage Optical, LLC
• Bethpage Pharmacy Inc
• Bethpage Physical Therapy Assoc PC
• Bethpage Union Free School District

• Internal Medicine Physician in Bethpage, NY
• Providers in Bethpage, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.