MEDICARE: DR. JAYSHREE BHASKARA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MA08290100	NJ
2	207R00000X	Internal Medicine Physician	68105	AZ

General Provider Information

NPI Number	:	1790771228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAYSHREE BHASKARA M.D.

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:
Fax Number	:	908-595-1410

Provider Business Practice Location Address
First Line	:	833 N DOBSON RD STE 103
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85201-7593
Country	:	US
Telephone Number	:	480-666-7683
Fax Number	:	888-498-4326

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	02/19/2026

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