Individual provider Active NPI

Bledi Hysa, MD

  • Student in an Organized Health Care Education/Training Program
  • Jackson, MI
National Provider Identifier
1992381768
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-7164
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

205 N East Ave
Jackson, MI 49201-1753

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
I20260312001998 NY Practitioner - Psychiatry 0749683910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York Downstate Medical Center, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

234 E 149 St
Bronx, NY 10451-5504

2758 Middle Country Rd
Lake Grove, NY 11755-2118

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Jan 20, 2026 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bhysa729721@direct.hfhs.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1992381768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYSA",
        "first_name": "BLEDI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.