Individual provider Active NPI

Iman Andalib, M.D.

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1144585126
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
283794 Issued in NY
Practice address
450 Clarkson Ave.
Brooklyn, NY 11203
Phone
(718) 270-1835
NPI assigned
Jul 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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 283794 NY Primary

Addresses

Primary practice location

450 Clarkson Ave.
Brooklyn, NY 11203

Mailing address

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180514002798 NJ Practitioner - Gastroenterology 4082978358 Reassigns benefits to 1 organization
I20191004001797 NY Practitioner - Gastroenterology 4082978358 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

20 Prospect Ave
Hackensack, NJ 07601-1997
Phone (551) 996-5045

Hospital & facility affiliations

  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Raritan Bay Medical Center Hospital, Perth Amboy, NJ, CCN 310039

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy36
Upper gastrointestinal (GI) endoscopy for acid reflux441

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
283794NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine Current Accepting new patients
Mount Sinai School of Medicine CurrentSince Aug 10, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2021 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Gastroenterology Current Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Aug 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Aug 1, 2023 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Jun 1, 2023 Accepting new patients
Mount Sinai School of Medicine CurrentSince Aug 10, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2021 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

516 Lawrie St
Perth Amboy, NJ 08861
Phone (732) 324-5000

2750 Merrick Rd
Bellmore, NY 11710
Phone (516) 409-2000

775 Park Ave
Huntington, NY 11743
Phone (631) 396-1595

2520 30th Ave
Long Island City, NY 11102
Phone (718) 267-4230

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

2965 Long Beach Rd
Oceanside, NY 11572
Phone (516) 593-8953

Interoperability endpoints

  • Direct secure messaging: iman.andalib@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 10

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 6

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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1144585126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11203",
            "telephone_number": "718-270-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDALIB",
        "first_name": "IMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "283794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.