NPIMap

Individual provider Active NPI

Mansoor M Nasim, MD, PHD

  • Anatomic Pathology Physician
  • New Hyde Park, NY
National Provider Identifier
1073629424
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
236585 Issued in NY
Practice address
270-05 76TH Ave, B68
New Hyde Park, NY 11040-1402
Phone
(718) 470-7490
Fax
(718) 347-9171
NPI assigned
Aug 21, 2006
Last updated
Dec 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 236585 NY Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD035352 DC

Addresses

Primary practice location

270-05 76TH Ave, B68
New Hyde Park, NY 11040-1402

Mailing address

270-05 76TH Ave, B68
New Hyde Park, NY 11040-1402
Phone (718) 470-7490

Other identifiers 3

IdentifierTypeStateIssuer
408656200MedicaidMD
010197171MedicaidVA
037027800MedicaidDC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081124000013 NY Practitioner - PathologyPractitioner - Neurosurgery 7012932676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Neurosurgery
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jan 3, 2012 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
North Shore - Lij Medical PC CurrentSince Jan 3, 2012 Accepting new patients
New York University CurrentSince Jul 1, 2022 Accepting new patients
New York University Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2022 Accepting new patients
Howard University Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

300 Community Dr
Manhasset, NY 11030

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

27005 76th Ave
North New Hyde Pk, NY 11040

100 Nicolls Rd
Rm 766
Stony Brook, NY 11790
Phone (631) 444-2222

100 Nicolls Rd
Stony Brook, NY 11790
Phone (631) 444-1069

Interoperability endpoints

  • Direct secure messaging: mansoor.nasim@direct.stonybrookmedicine.edu
  • Direct secure messaging: mnasim505164@nyumc.direct-ci.com

Organizations & group practices 6

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

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1073629424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270-05 76TH AVE, B68",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-7490",
            "fax_number": "718-347-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270-05 76TH AVE, B68",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-7490",
            "fax_number": "718-347-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASIM",
        "first_name": "MANSOOR",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "236585",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "DC",
            "license": "MD035352",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408656200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010197171",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037027800",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.