IKJOT S. BHUTANI


Address: 55 Lake Ave N, Department of Anatomic Pathology, Worcester, MA 01655-0002
Phone: 5087936100

IKJOT S. BHUTANI (NPI# 1801185335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801185335
Entity Type Individual
Full Name IKJOT S. BHUTANI
Credential MD
Practice Address 55 Lake Ave N
Department of Anatomic Pathology
Worcester
MA 01655-0002
Mailing Address Po Box 415348
Boston
MA 02241-5348
Practice Telephone 5087936100
Practice Fax Number 5087936110
Enumeration Date 2011-04-05
Last Update Date 2017-01-24
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207ZP0102X Pathology
Specialization: Anatomic Pathology & Clinical Pathology
262257 MA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MA 110114620A 05

Office Location

Street Address 55 LAKE AVE N
DEPARTMENT OF ANATOMIC PATHOLOGY
City WORCESTER
State MA
Zip Code 01655-0002

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477556587 James E Liebmann Internal Medicine 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 2005-05-23
1518568732 Justin Bullard Psychologist 55 Lake Ave N, Worcester, MA 01655-0002 2020-11-04
1346849825 Meghan Moore Nurse Practitioner 55 Lake Ave N, Worcester, MA 01655-0002 2020-10-26
1174122899 Jessica Goncalves Ferreira Nurse Practitioner 55 Lake Ave N, Worcester, MA 01655-0002 2020-10-23
1235746686 Desiree Mytych Student in an Organized Health Care Education/Training Program 55 Lake Ave N, Worcester, MA 01655-0002 2020-09-29
1659986248 Rebecca Lynn Harris Student in an Organized Health Care Education/Training Program 55 Lake Ave N, Worcester, MA 01655-0002 2020-09-10
1639781487 Gabriella Kathleen Holland Student in an Organized Health Care Education/Training Program 55 Lake Ave N, Worcester, MA 01655-0002 2020-08-21
1730791898 Kerry Anne Benedict Speech-Language Pathologist 55 Lake Ave N, Worcester, MA 01655-0002 2020-08-20
1902418999 Natasha R. Turner Genetic Counselor, MS 55 Lake Ave N, Worcester, MA 01655-0002 2020-08-20
1144830712 Abbey Corsini Nurse Practitioner 55 Lake Ave N, Worcester, MA 01655-0002 2020-08-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205489713 Darryl Sweeper Jr. Student in an Organized Health Care Education/Training Program 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 2019-07-23
1225690530 Ryan Zenevitch Student in an Organized Health Care Education/Training Program 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 2019-07-08
1932688454 Victoria Sayeg Student in an Organized Health Care Education/Training Program 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 2018-08-07
1114425675 Judith Dio Wentzell Social Worker Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 2018-01-30
1861927386 Muhammad Waqas Khan Student in an Organized Health Care Education/Training Program University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 2017-04-21
1861806192 Qaiser Shamshir Khan Psychiatry & Neurology 55 Lake Ave N # S7-831, Worcester, MA 01655 2014-06-14
1073858981 Heidi Glover Nurse Practitioner 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 2012-12-04
1972867992 Anna Bjornsdottir Psychiatry & Neurology 55 Lake Av N, Worcester, MA 01655 2012-06-25
1245567676 Steven Edward Mckinley Nurse Practitioner 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 2009-11-05
1851582951 Robin I Davidson Neurological Surgery 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 2007-08-05
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Taxonomy Information

Taxonomy Code 207ZP0102X
Grouping Allopathic & Osteopathic Physicians
Classification Pathology
Specialization Anatomic Pathology & Clinical Pathology

Taxonomy Definition

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720286370 Mark Davis Pathology 1 Innovation Dr Ste 3, Worcester, MA 01605-4306 2007-07-05
1629464334 Stephanie Petkiewicz Pathology 1 Innovation Dr, Biotech 3, Worcester, MA 01605-4307 2015-04-09
1316332398 Hiba Ibrahim Pathology 55 Lake Ave N, Worcester, MA 01655-0002 2015-04-06
1861819716 Jennifer L. Clark Pathology 55 Lake Ave N, Worcester, MA 01655-0002 2014-03-27
1154754372 Ali Sakhdari Pathology 1 Innovation Dr, Biotech 3, Worcester, MA 01605-4307 2013-08-12
1235492513 Qingqing Liu Pathology 1 Innovation Dr Ste 3, Worcester, MA 01605-4306 2012-06-21
1740541051 Amy G Zhou Pathology 55 Lake Ave N, Worcester, MA 01655-0002 2012-06-04
1568723864 Rebecca E Dedrick Pathology 55 Lake Ave N, Worcester, MA 01655-0002 2012-06-04
1427336056 Parnian Ahmadi Moghaddam Pathology 1 Innovation Dr, Biotech 3, Worcester, MA 01605-4307 2011-08-01
1346534609 Wei Xing Pathology 1 Innovation Dr, Biotech 3, Worcester, MA 01605-4307 2011-06-04
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City WORCESTER
Zip Code 01655

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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