Individual provider Active NPI

Niveditha Bhaskarla, M.D.

  • Psychiatry Physician
  • Miami, FL
National Provider Identifier
1871988741
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME128613 Issued in FL
Practice address
1190 NW 95TH St Ste 110
Miami, FL 33150
Phone
(305) 803-9469
NPI assigned
Mar 30, 2015
Last updated
Jun 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X ME128613 FL Primary

Addresses

Primary practice location

1190 NW 95TH St Ste 110
Miami, FL 33150

Mailing address

1190 NW 95TH St Ste 110
Miami, FL 33150-2064

Other practice location 1

3100 SW 62nd Ave
Miami, FL 33155-3009
Phone (305) 284-7500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180508000605 FL Practitioner - General Practice 8426312026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1190 NW 95TH St
Suite 110
Miami, FL 33150-2064
Phone (786) 353-2187

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME128613FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
B&B Psychiatry Associates LLC CurrentSince Sep 4, 2018 Accepting new patients
QMC LLC Past Accepting new patients

Locations

1190 NW 95th St
Ste 110
Miami, FL 33150
Phone (305) 696-7759

Organizations & group practices 2

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1871988741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331502064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33150",
            "telephone_number": "305-803-9469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331553009",
            "country_code": "US",
            "telephone_number": "305-284-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHASKARLA",
        "first_name": "NIVEDITHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME128613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.