Individual provider Active NPI

Mostaque Ahmed

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1003851064
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
219207 Issued in NY
Practice address
555 Rockaway Pkwy
Brooklyn, NY 11212-3132
Phone
(718) 240-5154
Fax
(718) 240-6924
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 219207 NY Primary

Addresses

Primary practice location

555 Rockaway Pkwy
Brooklyn, NY 11212-3132

Mailing address

8906 135TH St
7L
Richmond Hill, NY 11418-2834
Phone (718) 206-6984

Other identifiers 1

IdentifierTypeStateIssuer
01780414MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120307000162 NY Practitioner - Internal MedicinePractitioner - Pulmonary Disease 9537328794 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
000639NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
The Schulman and Schachne Institute for Nursing and Rehabilitation Inc. CurrentSince Jun 28, 2015 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Feb 1, 2013 Accepting new patients
The Schulman and Schachne Institute for Nursing and Rehabilitation Inc CurrentSince Jun 28, 2015 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Feb 1, 2013 Accepting new patients
TJH Medical Services, PC Past Accepting new patients

Locations

1235 Linden Blvd
Fl 1
Brooklyn, NY 11212
Phone (718) 975-8368

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

9413 Flatlands Ave
Ste 205W
Brooklyn, NY 11236
Phone (718) 257-4549

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

555 Rockaway Pkwy
Brooklyn, NY 11212
Phone (718) 240-5105

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1003851064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 135TH ST",
            "address_2": "7L",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182834",
            "telephone_number": "718-206-6984",
            "fax_number": "718-206-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 ROCKAWAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123132",
            "telephone_number": "718-240-5154",
            "fax_number": "718-240-6924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MOSTAQUE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01780414",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.