Provider Demographics
NPI:1538324959
Name:BHATTY, MUHAMMAD USMAN ANWAR (DO)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:USMAN ANWAR
Last Name:BHATTY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-5067
Mailing Address - Fax:585-922-2908
Practice Address - Street 1:1425 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-5067
Practice Address - Fax:585-922-2908
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249600207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ47907OtherUHP-NON PAR #
NJ0179850Medicaid
NJP00701243OtherRAILROAD MEDICARE
NJ147904ZCS7Medicare PIN
NYJ400057559Medicare PIN
NJ147904TM8Medicare PIN
NJP00701243OtherRAILROAD MEDICARE