Individual provider Active NPI

Sajid Mithaiwala, MD

  • Adolescent Medicine (Internal Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1093342032
Registry record updated Sep 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
326775 Issued in NY
Practice address
2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone
(718) 616-3000
NPI assigned
Mar 26, 2020
Last updated
Sep 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 326775 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2601 Ocean Pkwy
Brooklyn, NY 11235-7745

Mailing address

1000 Montauk Hwy
West Islip, NY 11795-4927

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
I20231222001426 NY Practitioner - Internal MedicinePractitioner - Hospitalist 2961852587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Suffolk Medical PCGroup PAC ID 0244396349, 204 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
326775NYMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 16, 2025 Accepting new patients
Southwest Suffolk Medical, P.C. Current Accepting new patients
Southwest Suffolk, P.C CurrentSince Nov 27, 2023 Accepting new patients
Southwest Suffolk Medical PC CurrentSince Nov 27, 2023 Accepting new patients
North Shore - Lij Medical PC CurrentSince Oct 16, 2025 Accepting new patients
Good Samaritan Hospital Medical Center Past Accepting new patients

Locations

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

300 Community Dr
Manhasset, NY 11030

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

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 2

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757808000000",
    "number": "1093342032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357745",
            "telephone_number": "718-616-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITHAIWALA",
        "first_name": "SAJID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-09-14",
        "certification_date": "2025-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "NY",
            "license": "326775",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.