Individual provider Active NPI

Jasmin Bafaiz, NP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1649869231
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309680 Issued in NY
Practice address
110 E 55TH St FL 14
New York, NY 10022-4585
Phone
(646) 665-3631
NPI assigned
Jan 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 309680 NY Primary

Addresses

Primary practice location

110 E 55TH St FL 14
New York, NY 10022-4585

Mailing address

110 E 55TH St FL 14
New York, NY 10022-4585
Phone (646) 665-3631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240906003008 CA Practitioner - Nurse Practitioner 7618357179 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95022274CAMDAmbulatory Care Registered Nurse
309680NYMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgery Center of Pure CurrentSince Jun 21, 2024 Accepting new patients
Pure Dermatology CurrentSince Jun 21, 2024 Accepting new patients

Locations

500 Superior Ave
Ste 335
Newport Beach, CA 92663
Phone (949) 706-1469

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1649869231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 55TH ST FL 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224585",
            "telephone_number": "646-665-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 55TH ST FL 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224585",
            "telephone_number": "646-665-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAFAIZ",
        "first_name": "JASMIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.