NPIMap

Individual provider Active NPI

Muhammad Ihsan, MD

  • Interventional Cardiology Physician
  • Brooklyn, NY
National Provider Identifier
1114210309
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
276145 Issued in NY
Practice address
450 Clarkson Ave # 1262
Brooklyn, NY 11203-2012
Phone
(718) 270-8867
NPI assigned
May 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 276145 NY
Internal Medicine Physician 207R00000X 054856 CT
Cardiovascular Disease Physician 207RC0000X 276145 NY
Interventional Cardiology Physician 207RI0011X 276145 NY Primary

Addresses

Primary practice location

450 Clarkson Ave # 1262
Brooklyn, NY 11203-2012

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

600 Northern Blvd Rm 519
Albany, NY 12204-1004
Phone (518) 471-4906

Other practice location 2

450 Clarkson Ave # 1262
Brooklyn, NY 11203-2012
Phone (718) 270-8867

Other practice location 3

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1550

Other practice location 4

2215 Burdett Avenue
Hospitalist Department
Troy, NY 12180
Phone (518) 271-3300

Other practice location 5

2 Palisades Drive
Albany Associates In Cardiology
Albany, NY 12205-1438
Phone (518) 458-2000

Other practice location 6

2 New Hampshire Ave Ste 200
Troy, NY 12180-1762
Phone (518) 458-2000

Other practice location 7

855 Route 146
Clifton Park, NY 12065-3885
Phone (518) 458-2000

Other practice location 8

156 Quaker Rd
Queensbury, NY 12804-1718
Phone (518) 458-2000

Other practice location 9

1735 Route 9
Halfmoon, NY 12065-2421
Phone (518) 458-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123002674 NY Practitioner - Interventional CardiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 7810297801 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Peter'S Health Partners Medical Associates, P.C.Group PAC ID 6103061189, 480 clinicians

Practice addresses (Care Compare)

2 Palisades Dr
Albany, NY 12205-1438
Phone (518) 458-2000

Hospital & facility affiliations

  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057
  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting15
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
St. Peter'S Hospital of the City of Albany Internal Medicine CurrentSince Oct 16, 2017 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Internal Medicine CurrentSince Jul 27, 2020 Accepting new patients
St. Peter'S Hospital of the City of Albany Internal Medicine CurrentSince Oct 16, 2017 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Internal Medicine Past Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Cardiovascular Disease Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

600 Northern Blvd
Rm 519
Albany, NY 12204
Phone (518) 471-4906

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

2 Palisades Dr
Albany, NY 12205

855 Route 146
Clifton Park, NY 12065
Phone (518) 438-2776

1735 Route 9
Halfmoon, NY 12065
Phone (518) 269-4690

156 Quaker Rd
Queensbury, NY 12804
Phone (518) 793-9063

2 New Hampshire Ave
Ste 200
Troy, NY 12180
Phone (518) 274-1947

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: mihsan789029@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1114210309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE # 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-8867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Northern Blvd Rm 519",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122041004",
            "country_code": "US",
            "telephone_number": "518-471-4906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Clarkson Ave # 1262",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-8867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Burdett Avenue",
            "address_2": "Hospitalist Department",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "12180",
            "country_code": "US",
            "telephone_number": "518-271-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Palisades Drive",
            "address_2": "Albany Associates In Cardiology",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122051438",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 New Hampshire Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801762",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 Route 146",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120653885",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "156 Quaker Rd",
            "address_purpose": "LOCATION",
            "city": "Queensbury",
            "state": "NY",
            "postal_code": "128041718",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1735 Route 9",
            "address_purpose": "LOCATION",
            "city": "Halfmoon",
            "state": "NY",
            "postal_code": "120652421",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IHSAN",
        "first_name": "MUHAMMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "276145",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "054856",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "276145",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "276145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "450 Clarkson Ave # 1262",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112032012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.