BIJAN BASTANINEJAD (M.D.) – Pediatrics Physician, NPI 1972589968
Pediatrics Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for BIJAN BASTANINEJAD (M.D.)
610 N One Mile Rd
Dexter, MO 638412539
Phone: (573) 624-3600
Type: Location
2620, North Westwood Boulevard, Loma Linda, Poplar Bluff, Butler County, Missouri, 63901, United States
POPLAR BLUFF, MO 639013396
Phone: (573) 785-7721
Fax: (573) 727-2465
Type: Mailing
3100 Oak Grove Rd
Poplar Bluff, MO 639011573
Phone: (573) 776-2000
Type: Location
PO BOX 1308
POPLAR BLUFF, MO 639021308
Phone: (573) 843-8380
Fax: (573) 843-8381
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $80.
Total Amount is formed as General ($80) + Research ($0) + Ownership ($0) = $80.
Last reported payment date: 2024-12-14 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($30).
Total Amount
$80
General + Research + Ownership
Payments
4
Total payment records
General Amount
$80
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-14
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-05-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100519000419 | I | Pediatric Medicine | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63841)
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