Individual provider Active NPI

Paul Bruce Bader, MD

  • Hematology & Oncology Physician
  • Rego Park, NY
National Provider Identifier
1740281450
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
143018 Issued in NY
Practice address
9785 Queens Blvd
Rego Park, NY 11374-3319
Phone
(718) 261-9100
Fax
(718) 997-0347
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 143018 NY Primary

Addresses

Primary practice location

9785 Queens Blvd
Rego Park, NY 11374-3319

Mailing address

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Other identifiers 2

IdentifierTypeStateIssuer
00840157MedicaidNY
143018OtherNYHIP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pbader25883@nyumc.direct-ci.com

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
I20070611000637 NY Practitioner - Hematology/Oncology 7719085935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923

9777 Queens Blvd
Rego Park, NY 11374-3335
Phone (718) 261-9100

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
143018NYMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 4, 2011 Accepting new patients
New York University CurrentSince Jul 4, 2011 Accepting new patients
Nyumc Radiology Associates Past Accepting new patients
New York University Past Accepting new patients
P. Bader & N. Gondal M.D. , P.C. Hematology & Oncology Past Accepting new patients

Locations

11247 Queens Blvd
Ste 209
Forest Hills, NY 11375
Phone (718) 263-7766

9777 Queens Blvd
Rego Park, NY 11374
Phone (718) 275-9300

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

6655 Fresh Pond Rd
Ridgewood, NY 11385
Phone (718) 497-1919

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Organizations & group practices 5

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 9

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": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1740281450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9785 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743319",
            "telephone_number": "718-261-9100",
            "fax_number": "718-997-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9785 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743319",
            "telephone_number": "718-261-9100",
            "fax_number": "718-997-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "PAUL",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "143018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00840157",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "143018",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbader25883@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "9785 Queens Blvd",
            "city": "Rego Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113743319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.