Individual provider Active NPI

Dimyan Balikcioglu, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1619984432
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
214100 Issued in NY
Practice address
841 Burke Ave
Bronx, NY 10467-6613
Phone
(718) 654-1726
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 214100 NY Primary

Addresses

Primary practice location

841 Burke Ave
Bronx, NY 10467-6613

Mailing address

841 Burke Ave
Bronx, NY 10467-6613
Phone (718) 654-1726

Other identifiers 1

IdentifierTypeStateIssuer
02134449MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109001112 NY Practitioner - Internal Medicine 8729001466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

841 Burke Ave
Bronx, NY 10467-6619
Phone (718) 654-1726

Hospital & facility affiliations

  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • Montefiore Med Ctr Home Care Chha Home health agency, Bronx, NY, CCN 337009
  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214100NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dimyan Balikcioglu MD PC Internal Medicine CurrentSince Mar 27, 2013 Accepting new patients
Our Lady of Mercy Medical Center Past Accepting new patients
Lifeline Medical Testing PLLC Past Accepting new patients

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1619984432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 BURKE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676613",
            "telephone_number": "718-654-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 BURKE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676613",
            "telephone_number": "718-654-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALIKCIOGLU",
        "first_name": "DIMYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02134449",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.