Individual provider Active NPI

Noreen Kamal-Mostafavi, MD

  • Obstetrics & Gynecology Physician
  • Staten Island, NY
National Provider Identifier
1073748018
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
27741821 Issued in NY
Practice address
3860 Victory Blvd FL 1
Staten Island, NY 10314-6720
Phone
(718) 370-2222
Fax
(718) 351-0311
NPI assigned
May 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA09580200 NJ
Obstetrics & Gynecology Physician 207V00000X 27741821 NY Primary

Addresses

Primary practice location

3860 Victory Blvd FL 1
Staten Island, NY 10314-6720

Mailing address

14 Bleeker PL
Staten Island, NY 10314-3727
Phone (201) 978-7146

Other practice location 1

1033 US Highway 46 Ste 105
Clifton, NJ 07013-2448
Phone (201) 978-7146

Other names 1

  • Dr. Noreen Kamal Former name

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
I20181114001362 NY Practitioner - Obstetrics/Gynecology 9335493121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09580200NJMDObstetrics & Gynecology Physician
27741821NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
R Mostafavi MD Ophthamologist PC CurrentSince Sep 1, 2018 Accepting new patients
Elite Gynecology, LLC Obstetrics & Gynecology Past Accepting new patients

Locations

3860 Victory Blvd
Staten Island, NY 10314
Phone (718) 370-2222

3860 Victory Blvd
#1
Staten Island, NY 10314
Phone (718) 370-2222

445 Clawson St
Staten Island, NY 10306
Phone (718) 351-0525

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: noreenkamalmostafavi.noreenkamalmostafavi@142034.advancedmd-direct.com
  • Direct secure messaging: nkamalmostafavi67318@northwell.direct-ci.com
  • Direct secure messaging: nkamal189826@ahs.direct-ci.com

Organizations & group practices 2

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": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1073748018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BLEEKER PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143727",
            "telephone_number": "201-978-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 VICTORY BLVD FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146720",
            "telephone_number": "718-370-2222",
            "fax_number": "718-351-0311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1033 US Highway 46 Ste 105",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070132448",
            "country_code": "US",
            "telephone_number": "201-978-7146",
            "fax_number": "718-370-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMAL-MOSTAFAVI",
        "first_name": "NOREEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA09580200",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "27741821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOREEN",
            "last_name": "KAMAL",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.