Irene Fadullon Bahta, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME71906 Issued in FL

Practice address

10794 Pines Blvd
Suite 203
Pembroke Pines, FL 33026-3920

Phone

(954) 392-5696

Fax

(954) 392-5668

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ibahta12652@mhsdirect.net

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.

• Bahta and Associates Inc

  • Infectious Disease Physician
  • Pembroke Pines, FL
  • NPI 1124220967

  Internal Medicine

  Medicare reassignment NPD
• Yemane B Bahta MD,PA

  • Infectious Disease Physician
  • Pembroke Pines, FL
  • NPI 1538550280
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1710060793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330267101",
            "telephone_number": "954-392-5696",
            "fax_number": "954-392-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD",
            "address_2": "SUITE 203",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-392-5696",
            "fax_number": "954-392-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHTA",
        "first_name": "IRENE",
        "middle_name": "FADULLON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME71906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Victoria Baez Amador
• Alejandro Jose Baez Gutierrez
• Lila De la Caridad Baez Lopez
• Stacy Ann Bahadur
• Bahta and Associates Inc
• Yemane B Bahta, MD
• Howard I Baikovitz, M.D.
• Tassle Bailey, COTA
• Bridgette Bain, ARNP
• Keyshauna Kenise Bain

• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.