Individual provider Active NPI

Sumaira Mahmood

  • Addiction (Substance Use Disorder) Registered Nurse
  • Brentwood, NY
National Provider Identifier
1063381218
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
940150 Issued in NY
Practice address
400 Crooked Hill Rd
Brentwood, NY 11717-1039
Phone
(631) 231-3232
NPI assigned
Nov 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 940150 NY Primary

Addresses

Primary practice location

400 Crooked Hill Rd
Brentwood, NY 11717-1039

Mailing address

233 W 10TH St
Deer Park, NY 11729-5915
Phone (929) 391-8536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
940150NYMDAddiction (Substance Use Disorder) Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Development Corperation CurrentSince Nov 9, 2025 Accepting new patients

Locations

400 Crooked Hill Rd
Brentwood, NY 11717
Phone (631) 231-3232

Organizations & group practices 1

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": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1063381218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 W 10TH ST",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295915",
            "telephone_number": "929-391-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CROOKED HILL RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171039",
            "telephone_number": "631-231-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "SUMAIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "940150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.