BASHYAM IYENGAR MD NPI 1205137403

NPI Information

  • NPI: 1205137403
  • Provider Name: BASHYAM IYENGAR, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1760 EDGEWOOD AVE W STE B
    SUITE B
    JACKSONVILLE, FL
    ZIP 32208
  • Phone: (904) 358-8480

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NPI Details

Bashyam Iyengar, MD is a family medicine in Jacksonville, FL with 22 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Bashyam Iyengar, MD NPI is 1205137403. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1760 EDGEWOOD AVE W STE B
SUITE B
JACKSONVILLE, FL
ZIP 32208-209
Phone: (904) 358-8480
Fax: (904) 358-8460

The NPI 1205137403 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Transitional care management services for problem of moderate complexity (HCPCS:99495)
  • Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)

The enumeration date for this NPI number is 11/4/2010 and was last updated on 5/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine25MA08303600NEW JERSEYNo
2207Q00000XFamily Medicine255281-1NEW YORKNo
3207Q00000XFamily MedicineMD60189759WASHINGTONNo
4207Q00000XFamily MedicineME110643FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003130827AMEDICAIDGEORGIA
2HA612ZMEDICARE PINFLORIDA
3008479700MEDICAIDFLORIDA
414P8ZOTHERFLORIDABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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