Individual provider Active NPI

Hossam Adham, MD

  • Physical Medicine & Rehabilitation Physician
  • Staten Island, NY
National Provider Identifier
1164714010
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
281144 Issued in NY
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-9000
Fax
(718) 226-8695
NPI assigned
May 11, 2011
Last updated
Aug 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 281144 NY Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

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
I20170111002476 NY Practitioner - Physical Medicine and Rehabilitation 8022399773 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Ralph PL
Suite 204
Staten Island, NY 10304-4405
Phone (718) 885-5620

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
281144NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Healthcare Services PLLC CurrentSince Nov 30, 2016 Accepting new patients
Front Street Medical, P.C. CurrentSince Jun 6, 2020 Accepting new patients
Hospitalist Healthcare Services PLLC CurrentSince Nov 30, 2016 Accepting new patients
Smart Care Medical PC CurrentSince Mar 19, 2019 Accepting new patients

Locations

641 W 230th St
Bronx, NY 10463
Phone (646) 285-1720

1942 Bath Ave
Brooklyn, NY 11214
Phone (718) 265-5157

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

11909 26th Ave
Flushing, NY 11354
Phone (718) 434-0600

2308 30th Ave
Long Island City, NY 11102
Phone (718) 726-2000

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

11 Ralph Pl
Ste 204
Staten Island, NY 10304
Phone (347) 286-0741

100 Lake Rd
Vly Cottage, NY 10989
Phone (845) 268-6813

Networks

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

Interoperability endpoints

  • Direct secure messaging: hadham101664@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, 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": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1164714010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9000",
            "fax_number": "718-226-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9000",
            "fax_number": "718-226-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADHAM",
        "first_name": "HOSSAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-11",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "281144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.