Individual provider Active NPI

Sophia Bezirganian, MD

  • Psychiatry Physician
  • Elmira, NY
National Provider Identifier
1700979572
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
167463 Issued in NY
Practice address
1003 Walnut St
Elmira, NY 14901-1007
Phone
(607) 732-5646
Fax
(607) 732-0373
NPI assigned
Oct 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 167463 NY Primary

Addresses

Primary practice location

1003 Walnut St
Elmira, NY 14901-1007

Mailing address

211 N Geneva St
Ithaca, NY 14850-4135
Phone (607) 273-7494

Other identifiers 1

IdentifierTypeStateIssuer
01400417MedicaidNY

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
I20051221000293 NY Practitioner - Psychiatry 3476575275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical College of Pennsylvania, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1083 Waterloo Geneva Rd
Waterloo, NY 13165-1202
Phone (315) 856-8257

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Cayuga Counties Chapter Nysarc, Inc. CurrentSince Mar 10, 2014 Accepting new patients
Seneca Cayuga Counties Chapter Nysarc, Inc. CurrentSince Mar 10, 2014 Accepting new patients
Family & Children's Service of Ithaca Inc PastSince Jan 1, 1992 Accepting new patients
Chemung-Schuyler Counties Chapter, Nysarc, Inc. Past Accepting new patients
Nysarc Inc., Chemung County Chapter Past Accepting new patients
State of New York Comptrollers Office Past Accepting new patients

Locations

1521 Clark Street Rd
Auburn, NY 13021
Phone (315) 253-7331

1083 Waterloo Geneva Rd
Waterloo, NY 13165
Phone (315) 539-4049

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700979572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N GENEVA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504135",
            "telephone_number": "607-273-7494",
            "fax_number": "607-732-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WALNUT ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149011007",
            "telephone_number": "607-732-5646",
            "fax_number": "607-732-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZIRGANIAN",
        "first_name": "SOPHIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "167463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01400417",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.