Individual provider Active NPI

Arain Mohammad Nawaz, MD

  • Gastroenterology Physician
  • Port Jefferson, NY
National Provider Identifier
1083603070
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
124365 Issued in NY
Practice address
620 Belle Terre Rd
Suite 1
Port Jefferson, NY 11777-2500
Phone
(631) 928-0240
Fax
(631) 928-0855
NPI assigned
Oct 21, 2005
Last updated
Mar 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 124365 NY Primary

Addresses

Primary practice location

620 Belle Terre Rd
Suite 1
Port Jefferson, NY 11777-2500

Mailing address

620 Belle Terre Rd
Suite 1
Port Jefferson, NY 11777-2500
Phone (631) 928-0240

Other identifiers 1

IdentifierTypeStateIssuer
00442388MedicaidNY

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
I20050316001102 NY Practitioner - Gastroenterology 0345295986 Practice locations: Port Jefferson, NY

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

620 Belle Terre Rd
Port Jefferson, NY 11777-2500
Phone (631) 928-0240

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy63
Upper gastrointestinal (GI) endoscopy for acid reflux31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimed Health, LLC Gastroenterology CurrentSince Aug 9, 2016 Accepting new patients
Virtual Health Group PLLC Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1083603070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BELLE TERRE RD",
            "address_2": "SUITE 1",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772500",
            "telephone_number": "631-928-0240",
            "fax_number": "631-928-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BELLE TERRE RD",
            "address_2": "SUITE 1",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772500",
            "telephone_number": "631-928-0240",
            "fax_number": "631-928-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAWAZ",
        "first_name": "ARAIN",
        "middle_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "124365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00442388",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

Verify at the official NPI Registry.