Individual provider Active NPI

Abd-Manaaf Bakere

  • Physician Assistant
  • New York, NY
National Provider Identifier
1083418552
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033424 Issued in NY
Practice address
1901 1St Ave
New York, NY 10029-7494
Phone
(212) 423-6262
NPI assigned
Apr 3, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 033424 NY Primary

Addresses

Primary practice location

1901 1St Ave
New York, NY 10029-7494

Mailing address

1901 1St Ave
New York, NY 10029-7494
Phone (212) 423-6262

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250818000841 NY Practitioner - Physician Assistant 9739688748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7901 Broadway
Elmhurst, NY 11373-1329

7901 Broadway
D1 27
Elmhurst, NY 11373-1368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033424NYMDPhysician Assistant

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Jul 1, 2025 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jul 1, 2025 Accepting new patients

Locations

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: abakere3957962@nychhc.direct-ci.com

Organizations & group practices 3

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": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1083418552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297494",
            "telephone_number": "212-423-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297494",
            "telephone_number": "212-423-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKERE",
        "first_name": "ABD-MANAAF",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.