Individual provider Active NPI

Ali Reza Bakhshalizadeh, M.D.

  • Anesthesiology Physician
  • New Britain, CT
National Provider Identifier
1609925429
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
49505 Issued in CT
Practice address
100 Grand St
New Britain, CT 06052-2016
Phone
(860) 224-5011
NPI assigned
Jan 10, 2007
Last updated
Aug 26, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD439911 PA
Anesthesiology Physician 207L00000X 49505 CT Primary

Addresses

Primary practice location

100 Grand St
New Britain, CT 06052-2016

Mailing address

11781 Lee Jackson Memorial Hwy
Fairfax, VA 22033-3309
Phone (571) 777-5164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CT, RI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20101214000727 PA Practitioner - Anesthesiology 8628265899 Reassigns benefits to 2 organizations
I20110502000753 CT Practitioner - Anesthesiology 8628265899 Reassigns benefits to 2 organizations
I20161012000220 RI Practitioner - Anesthesiology 8628265899 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD439911PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia Connecticut PC Anesthesiology CurrentSince Oct 1, 2015 Accepting new patients
Geisinger Clinic Current Accepting new patients
Resource Anesthesiology Associates of CT PC Anesthesiology CurrentSince Oct 6, 2014 Accepting new patients
Geisinger Clinic CurrentSince Dec 1, 2015 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Anesthesiology CurrentSince Mar 1, 2015 Accepting new patients
Memorial Hospital Anesthesiology Past Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Anesthesiology Past Accepting new patients

Locations

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

539 Danbury Rd
Wilton, CT 06897
Phone (203) 834-7700

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

100 N Academy Ave
Danville, PA 17822

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

Organizations & group practices 8

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1609925429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11781 LEE JACKSON MEMORIAL HWY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333309",
            "telephone_number": "571-777-5164",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAND ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060522016",
            "telephone_number": "860-224-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKHSHALIZADEH",
        "first_name": "ALI",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD439911",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "49505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.