Individual provider Active NPI

Syd Bakshandeh, M.D.

  • Internal Medicine Physician
  • Ventura, CA
National Provider Identifier
1982820932
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C 41847 Issued in CA
Practice address
200 S Wells Rd
Suite 200
Ventura, CA 93004-1377
Phone
(805) 647-6322
Fax
(805) 647-7164
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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 C 41847 CA Primary

Addresses

Primary practice location

200 S Wells Rd
Suite 200
Ventura, CA 93004-1377

Mailing address

200 S Wells Rd
Suite 200
Ventura, CA 93004-1377
Phone (805) 647-6322

Other identifiers 1

IdentifierTypeStateIssuer
C 41847OtherCACALIFORNIA MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070806000632 CA Practitioner - Internal MedicinePractitioner - Nephrology 3870684806 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C 41847CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc Current Accepting new patients
Clinicas del Camino Real Inc CurrentSince Jan 3, 2010 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Jan 3, 2010 Accepting new patients

Locations

355 Central Ave
Fillmore, CA 93015
Phone (805) 524-4926

1200 Maricopa Hwy
Ojai, CA 93023
Phone (805) 640-8293

650 Meta St
Oxnard, CA 93030
Phone (805) 487-5351

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

200 S Wells Rd
Ste 200
Ventura, CA 93004
Phone (805) 647-6322

Interoperability endpoints

  • Direct secure messaging: syd.bakshandeh.p1@direct.clinicas.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1982820932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S WELLS RD",
            "address_2": "SUITE 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041377",
            "telephone_number": "805-647-6322",
            "fax_number": "805-647-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WELLS RD",
            "address_2": "SUITE 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041377",
            "telephone_number": "805-647-6322",
            "fax_number": "805-647-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKSHANDEH",
        "first_name": "SYD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C 41847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL BOARD",
            "identifier": "C 41847",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.