Organization Active NPI

Ahamed S Moideen MD PC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Flushing, NY
National Provider Identifier
1164616116
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
132106 Issued in NY
Legal business name
AHAMED S MOIDEEN MD PC
Practice address
142 04 Bayside Ave
Ste 5L
Flushing, NY 11354-2331
Phone
(718) 359-8346
Fax
(718) 359-8342
NPI assigned
Sep 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Ahamed S Moideen, MD FACS FCCP RPVINPI 1982667549
Title
President
Phone
(718) 359-8346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X 132106 NY
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X 132106 NY Primary

Addresses

Primary practice location

142 04 Bayside Ave
Ste 5L
Flushing, NY 11354-2331

Mailing address

142 04 Bayside Ave
Ste 5L
Flushing., NY 11354-2331
Phone (718) 359-8346

Other identifiers 1

IdentifierTypeStateIssuer
00612253MedicaidNY

National Provider Directory

National Provider Directory

Locations

14204 Bayside Ave
Ste 5L
Flushing, NY 11354
Phone (718) 359-8346

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1164616116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 04 BAYSIDE AVE",
            "address_2": "STE 5L",
            "city": "FLUSHING.",
            "state": "NY",
            "postal_code": "113542331",
            "telephone_number": "718-359-8346",
            "fax_number": "718-359-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 04 BAYSIDE AVE",
            "address_2": "STE 5L",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113542331",
            "telephone_number": "718-359-8346",
            "fax_number": "718-359-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHAMED S MOIDEEN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "MOIDEEN",
        "authorized_official_first_name": "AHAMED",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-359-8346",
        "authorized_official_credential": "MD FACS FCCP RPVI"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "132106",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "132106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00612253",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.