Individual provider Active NPI

Aqsa Nisar, M.B.B.S.

  • Student in an Organized Health Care Education/Training Program
  • Staten Island, NY
National Provider Identifier
1093381246
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
475 Seaview Avenue
Staten Island
Staten Island, NY 10305
Phone
(718) 226-8855
Fax
(718) 226-1347
NPI assigned
May 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

475 Seaview Avenue
Staten Island
Staten Island, NY 10305

Mailing address

475 Seaview Avenue
Staten Island
Staten Island, NY 10305
Phone (718) 226-8855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20241023004312 NJ Practitioner - Internal Medicine 1153854567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine of Morris County LLCGroup PAC ID 2466428388, 77 clinicians

Practice addresses (Care Compare)

25 Pocono Rd
Denville, NJ 07834-2954
Phone (973) 927-5788

400 W Blackwell St
Dover, NJ 07801-2525
Phone (973) 927-5788

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of Morris County LLC CurrentSince Aug 12, 2024 Accepting new patients
Prime Healthcare Services - Saint Clare'S LLC Past Accepting new patients

Locations

25 Pocono Rd
Denville, NJ 07834
Phone (273) 625-6000

400 W Blackwell St
Dover, NJ 07801
Phone (973) 537-3818

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.

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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1093381246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVENUE",
            "address_2": "STATEN ISLAND",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-8855",
            "fax_number": "718-226-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVENUE",
            "address_2": "STATEN ISLAND",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-8855",
            "fax_number": "718-226-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISAR",
        "first_name": "AQSA",
        "name_prefix": "Ms.",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2024-10-08",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.