Individual provider Active NPI

Muhammad Z Qureshi, MD

  • Pediatric Critical Care Medicine Physician
  • Shreveport, LA
National Provider Identifier
1215036348
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
MD.204068 Issued in LA
Practice address
2510 Bert Kouns Loop
Suite 4003
Shreveport, LA 71118-3119
Phone
(318) 212-5665
Fax
(318) 212-5698
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 199993 NY
Pediatric Critical Care Medicine Physician 2080P0203X 199993 NY
Pediatric Critical Care Medicine Physician 2080P0203X MD.204068 LA Primary

Addresses

Primary practice location

2510 Bert Kouns Loop
Suite 4003
Shreveport, LA 71118-3119

Mailing address

2510 Bert Kouns Loop
Suite 4003
Shreveport, LA 71118-3119
Phone (318) 212-5665

Other identifiers 4

IdentifierTypeStateIssuer
184380001MedicaidAR
02315740MedicaidNY
215821401MedicaidTX
2120450MedicaidLA

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
I20050113000595 NY Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8820047145 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.204068LAMDPediatric Critical Care Medicine Physician
199993NYMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Pediatric Critical Care Medicine CurrentSince Mar 26, 2019 Accepting new patients
Albany Medical College CurrentSince Mar 26, 2019 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Sep 1, 2020 Accepting new patients
Albany Medical College Current Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

Interoperability endpoints

  • Direct secure messaging: mqureshi28626@albanymed.direct-ci.com

Organizations & group practices 5

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1215036348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 BERT KOUNS LOOP",
            "address_2": "SUITE 4003",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183119",
            "telephone_number": "318-212-5665",
            "fax_number": "318-212-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 BERT KOUNS LOOP",
            "address_2": "SUITE 4003",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183119",
            "telephone_number": "318-212-5665",
            "fax_number": "318-212-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "MUHAMMAD",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NY",
            "license": "199993",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "199993",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "LA",
            "license": "MD.204068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184380001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02315740",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215821401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2120450",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.