Internal Medicine and Wellness Therapies Medical Office Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A048709 Issued in CA

Legal business name

INTERNAL MEDICINE AND WELLNESS THERAPIES MEDICAL OFFICE INC

Doing business as

Internal Medicine and Wellness Therapies Medical Office Inc

Practice address

6815 Fair Oaks Blvd
Carmichael, CA 95608-3868

Phone

(916) 481-4389

Fax

(916) 481-4307

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Kathrine Bayard Bisharat, MD

Title

President

Phone

(916) 481-4389

Specialties & licenses 1

Addresses

Other names 1

• INTERNAL MEDICINE AND WELLNESS THERAPIES MEDICAL OFFICE INC Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Bayard Bisharat, MD

  • Internal Medicine Physician
  • Carmichael, CA
  • NPI 1801861547
  Medicare reassignment NPD
• Sarah Ruby Hendricks, NP

  • Nurse Practitioner
  • Sacramento, CA
  • NPI 1215690698
  Medicare reassignment NPD
• Katherine Cunha, PA-C

  • Medical Physician Assistant
  • Folsom, CA
  • NPI 1710381041
  Medicare reassignment
• Chienwei Kung, PA-C

  • Physician Assistant
  • Carmichael, CA
  • NPI 1689948168
  Medicare reassignment

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1750427506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956083868",
            "telephone_number": "916-481-4389",
            "fax_number": "916-481-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956083868",
            "telephone_number": "916-481-4389",
            "fax_number": "916-481-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE AND WELLNESS THERAPIES MEDICAL OFFICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "BISHARAT",
        "authorized_official_first_name": "KATHRINE",
        "authorized_official_middle_name": "BAYARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-481-4389",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A048709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTERNAL MEDICINE AND WELLNESS THERAPIES MEDICAL OFFICE INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.