Organization Active NPI

Momentstore LLC

  • Physical Medicine & Rehabilitation Physician
  • Jamaica, NY
National Provider Identifier
1184547150
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MOMENTSTORE LLC
Practice address
17860 Wexford Ter Apt 1E
Jamaica, NY 11432-3018
Phone
(456) 456-4564
NPI assigned
Aug 4, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Muhammad Qayyum
Title
Ceo
Phone
(456) 456-4564

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

17860 Wexford Ter Apt 1E
Jamaica, NY 11432-3018

Mailing address

17860 Wexford Ter Apt 1E
Jamaica, NY 11432-3018

National Provider Directory

National Provider Directory
Tax ID family
Momentstore LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1785801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1184547150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17860 WEXFORD TER APT 1E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17860 WEXFORD TER APT 1E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323018",
            "telephone_number": "456-456-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTSTORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-04",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "QAYYUM",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "456-456-4564"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.