Individual provider Active NPI

Sabrina Mustafa

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1164168167
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028908 Issued in NY
Practice address
1 Campus Rd
Staten Island, NY 10301-4479
Phone
(718) 390-3100
NPI assigned
May 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 028908 NY Primary

Addresses

Primary practice location

1 Campus Rd
Staten Island, NY 10301-4479

Mailing address

49 Fritchie PL
Valley Stream, NY 11580-2514
Phone (516) 554-1134

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230525003022 NY Practitioner - Physician Assistant 9032575519 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Oct 1, 2024 Accepting new patients
Jamaica Hospital CurrentSince Oct 1, 2024 Accepting new patients
New York University CurrentSince Apr 18, 2023 Accepting new patients
New York University CurrentSince Apr 18, 2023 Accepting new patients

Locations

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: smustafa539035@nyumc.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1164168167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 FRITCHIE PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802514",
            "telephone_number": "516-554-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CAMPUS RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014479",
            "telephone_number": "718-390-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "SABRINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.