Individual provider Active NPI

Pinakin G Bhakta, M.D.

  • Internal Medicine Physician
  • Glendale, AZ
National Provider Identifier
1760438618
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27723 Issued in AZ
Practice address
17100 N 67TH Ave
Suite 602
Glendale, AZ 85308-3605
Phone
(602) 978-5005
Fax
(602) 978-1115
NPI assigned
May 25, 2006
Last updated
Sep 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27723 AZ Primary

Addresses

Primary practice location

17100 N 67TH Ave
Suite 602
Glendale, AZ 85308-3605

Mailing address

17100 N 67TH Ave
Suite 602
Glendale, AZ 85308-3605
Phone (602) 978-5005

Other identifiers 1

IdentifierTypeStateIssuer
485434MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050316001017 AZ Practitioner - Internal Medicine 1254386873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17100 N 67TH Ave
Suite 602
Glendale, AZ 85308-4510

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27723AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinakin G. Bhakta M.D.,P.C. Internal Medicine CurrentSince Feb 18, 2011 Accepting new patients

Locations

17100 N 67th Ave
Ste 602
Glendale, AZ 85308
Phone (602) 978-5005

Organizations & group practices 1

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 2

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1760438618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 N 67TH AVE",
            "address_2": "SUITE 602",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083605",
            "telephone_number": "602-978-5005",
            "fax_number": "602-978-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 N 67TH AVE",
            "address_2": "SUITE 602",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083605",
            "telephone_number": "602-978-5005",
            "fax_number": "602-978-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "PINAKIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "27723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "485434",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.