Provider Demographics
NPI:1801995642
Name:BHIMASANI, HEMANTH KUMAR (MD,)
Entity type:Individual
Prefix:DR
First Name:HEMANTH
Middle Name:KUMAR
Last Name:BHIMASANI
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 LOIS LN
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-2561
Mailing Address - Country:US
Mailing Address - Phone:814-861-3012
Mailing Address - Fax:
Practice Address - Street 1:321 LOIS LN
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2561
Practice Address - Country:US
Practice Address - Phone:814-861-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 4240852084P0800X
NE242722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00728210OtherRAILROAD MEDICARE
NE47066229013Medicaid
PA1010400300001Medicaid
PA083611GUWMedicare ID - Type Unspecified
PAH83105Medicare UPIN
PA1010400300001Medicaid