BAKTASH BOOTORABI (NPI# 1992758551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992758551 |
| Entity Type | Individual |
| Full Name | BAKTASH BOOTORABI |
| Credential | MD |
| Practice Address |
50 Leroy St Potsdam NY 13676-2051 |
| Mailing Address |
1116 Arsenal St Suite 504 Watertown NY 13601-2229 |
| Practice Telephone | 3157822620 |
| Mailing Telephone | 3157822620 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
225867-1 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
50 LEROY ST |
| City | POTSDAM |
| State | NY |
| Zip Code | 13676-2051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598761801 | Amit J Shanker | Internal Medicine | 50 Leroy St, Potsdam, NY 13676-1786 | 2005-06-22 |
| 1154937431 | Felicity Lynn Love | Occupational Therapist | 50 Leroy St, Potsdam, NY 13676-1799 | 2020-09-22 |
| 1265041073 | Zachary Randall Willis | Physician Assistant | 50 Leroy St, Potsdam, NY 13676-1799 | 2020-07-28 |
| 1780293993 | Gary Thomas Sniffen | Physician Assistant | 50 Leroy St, Potsdam, NY 13676-1799 | 2020-07-24 |
| 1437776176 | Megan Mae O'brien | Physician Assistant | 50 Leroy St, Potsdam, NY 13676-1799 | 2020-06-29 |
| 1033748355 | Kelsey Miller | Pharmacist | 50 Leroy St, Potsdam, NY 13676-1786 | 2020-04-07 |
| 1548800196 | Alexandria Fons | Dietitian, Registered | 50 Leroy St, Potsdam, NY 13676-1799 | 2020-01-12 |
| 1235775123 | Kacie Nicole Wentworth | Occupational Therapist | 50 Leroy St, Potsdam, NY 13676-1786 | 2019-11-26 |
| 1326682204 | Megan Lyn Boyea | Speech-Language Pathologist | 50 Leroy St, Potsdam, NY 13676-1786 | 2019-11-04 |
| 1912569955 | Stephanie F Rogers | Hospitalist | 50 Leroy St, Potsdam, NY 13676-1799 | 2019-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477170702 | Lucille D'agostino | Nurse Practitioner | 6805 State Highway 11, Potsdam, NY 13676 | 2020-07-02 |
| 1942851969 | Carrie E Sullivan | Counselor | 6956 Ny-56, Potsdam, NY 13676 | 2019-09-20 |
| 1508425786 | David M. Hurlbut Dds Pllc | Dentist | 145 1/2 Market Street, Suite A, Potsdam, NY 13676 | 2019-06-11 |
| 1609358902 | Sara Anne O'brian Polniak | Counselor | 20 Cottage Street, Potsdam, NY 13676 | 2018-09-04 |
| 1215451067 | Sunday Wright Smith | Advanced Practice Midwife | 34 Lawrence Avenue, Potsdam, NY 13676 | 2017-08-02 |
| 1992239891 | Michael Paul Wendell | Nurse Anesthetist, Certified Registered | Canton-potsdam Hospital, 50 Leroy Street, Potsdam, NY 13676 | 2017-04-18 |
| 1023561495 | Rocky Mountain Holdings, LLC | Ambulance | 150 Hatch Rd, Potsdam, NY 13676 | 2016-08-02 |
| 1942658398 | Samantha Lucas | Physician Assistant | 49 Lawrence, Urgent Care, Potsdam, NY 13676 | 2016-05-26 |
| 1205237880 | State Hearing and Audiology, PC | Audiologist-Hearing Aid Fitter | 6604 State Route 56, Potsdam, NY 13676 | 2014-09-15 |
| 1649607888 | Talia Elizabeth Foster | Acupuncturist | 22 Depot St. Suite 13, Potsdam, NY 13676 | 2013-10-02 |
| Find all providers in zip 13676 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396257721 | Meggyn Everhart | Radiology | 50 Leroy St, Potsdam, NY 13676-1786 | 2017-10-25 |
| 1710305115 | Jubin Jacob | Radiology | 50 Leroy St, Potsdam, NY 13676-1786 | 2014-04-02 |
| 1053370742 | Glauco Michael Maresca | Radiology | 50 Leroy St, Canton-potsdam Hospital, Potsdam, NY 13676-1786 | 2006-03-21 |
| 1154380863 | St Lawrence Radiology Assoc PC | Radiology | 50 Leroy St, Canton Potsdam Hospital, Potsdam, NY 13676-1786 | 2006-03-21 |
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| 1215550462 | Hudson Valley Radiologists, PC | Radiology | 50 Leonard St Unit 106, Beacon, NY 12508-3455 | 2020-05-22 |
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| 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.