Bijan Bastaninejad, MD | |
2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | |
(573) 785-7721 | |
(573) 727-2465 |
Full Name | Bijan Bastaninejad |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 2620 N Westwood Blvd, Poplar Bluff, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972589968 | NPI | - | NPPES |
40113 | Other | MI | HPM |
02695054 | Medicaid | NY | |
000000488786 | Other | OH | ANTHEM |
4920459 | Medicaid | MI | |
5202199 | Medicaid | MI | |
7210867 | Other | OH | AETNA |
05227 | Other | OH | PARAMOUNT |
2678446 | Medicaid | OH | |
237324 | Other | NY | BLUECROSS BLUESHIELD |
000000520832 | Other | OH | ANTHEM |
Entity Name | Big Springs Medical Association |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225045321 PECOS PAC ID: 6709871007 Enrollment ID: O20040416000695 |
Entity Name | Poplar Bluff Hma Physician Management, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598710147 PECOS PAC ID: 5092769703 Enrollment ID: O20050307000013 |
Entity Name | Poplar Bluff Regional Medical Center Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750797775 PECOS PAC ID: 6800707225 Enrollment ID: O20071116000008 |
Entity Name | Butler Physician Services, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982056545 PECOS PAC ID: 6608164561 Enrollment ID: O20161007001160 |
Entity Name | St Louis Medical Associates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902500630 PECOS PAC ID: 5193185601 Enrollment ID: O20230715000583 |
Mailing Address | Practice Location Address |
---|---|
Bijan Bastaninejad, MD Po Box 1308, Poplar Bluff, MO 63902-1308 Ph: (573) 843-8380 | Bijan Bastaninejad, MD 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 Ph: (573) 785-7721 |
Sushmita Thota, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2879 James Blvd, Poplar Bluff, MO 63901 Phone: 214-566-8275 | |
Dr. Rangsan Suvan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 Lucy Lee Parkway, Poplar Bluff, MO 63901 Phone: 573-686-2585 Fax: 573-686-4415 | |
Dr. Claudia Karin Preuschoff, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599 | |
Gift Adanma Onyenso, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599 | |
Dr. Debra Ann Robertson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599 | |
Mr. Joseph P Fernando, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2340 Katy Ln, Suite 120, Poplar Bluff, MO 63901 Phone: 573-776-7393 Fax: 573-776-7396 | |
Dr. Shaun A Ross, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599 |