Individual provider Active NPI

Abdelouahed Elmouchtari, M.D.

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1154393932
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
226445 Issued in NY
Practice address
450 Clarkson Ave
Box # 1203
Brooklyn, NY 11203-2056
Phone
(718) 270-2022
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 226445 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Box # 1203
Brooklyn, NY 11203-2056

Mailing address

61 Somerset Rd
Hopewell Junction, NY 12533-3234
Phone (718) 759-9143

Other identifiers 1

IdentifierTypeStateIssuer
02475749MedicaidNY

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
I20230511003078 NY Order and Referring Only - PsychiatryPractitioner - Psychiatry 1153425095

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Downstate Mental Hygiene Associates Past Accepting new patients
Saint Francis Hospital / Medicine Past Accepting new patients
Spectrum Behavioral Management Services, Inc. Psychiatry Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aelmouchtari1052158@nychhc.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1154393932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 SOMERSET RD",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125333234",
            "telephone_number": "718-759-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX # 1203",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMOUCHTARI",
        "first_name": "ABDELOUAHED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "226445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02475749",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.