Mohammed Kashan Ahmed, RPA-C
Individual provider Active NPI Physician Assistant · Mineola, NY
NPI 1124302229 · NPPES record last updated Aug 8, 2022
Key facts
- NPI
- 1124302229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 015175 (NY)
- Practice address
- 259 1St St
Mineola, NY 11501-3957 - Phone
- (516) 663-8850
- NPI assigned
- Oct 6, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191114001866 | NY | Order and Referring Only - Physician Assistant | 5193980399 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015175 | NY | MD | Physical Therapy Assistant |
Interoperability endpoints
- mahmed285149@nyumc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 015175 | NY | Yes |
Addresses
Primary practice location
259 1St St
Mineola, NY 11501-3957
Mailing address
129 Glen Rd
North Babylon, NY 11703-4411
Phone (516) 508-0836
Other practice location 1
1484 E 87th St
Brooklyn, NY 11236-5138
Phone (347) 554-8535
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mahmed285149@nyumc.direct-ci.com |
Other providers in Mineola, NY
- Marc Adam Agulnick
- Nureen Ahammed
- Moira Kathleen Ahearne
- Sumbal Ahmad
- Kinza Ahmed
- Nina Ahmed
- Qanta A Ahmed
- Rehel Ahmed
- Syed Asim Ahmed
- Serin Ahn
All providers in Mineola, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.