Individual provider Active NPI

Sajid Mohamed, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Queens Village, NY
National Provider Identifier
1215377106
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016596 Issued in NY
Practice address
22218 93Rd Rd
Queens Village, NY 11428-1936
Phone
(917) 683-4182
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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 016596 NY Primary

Addresses

Primary practice location

22218 93Rd Rd
Queens Village, NY 11428-1936

Mailing address

22218 93Rd Rd
Queens Village, NY 11428-1936
Phone (917) 683-4182

Other practice location 1

150 55th St
Brooklyn, NY 11220-2508
Phone (718) 630-6745

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smohamed141583@nyumc.direct-ci.com

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
I20131017000551 NY Practitioner - Physician Assistant 0244464642 Reassigns benefits to 2 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
New York University CurrentSince Feb 20, 2017 Accepting new patients
New York University CurrentSince Feb 20, 2017 Accepting new patients
Montefiore Medical Center CurrentSince Aug 15, 2013 Accepting new patients
Montefiore Medical Center CurrentSince Aug 15, 2013 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

2475 Saint Raymonds Ave
Bronx, NY 10461
Phone (718) 430-7300

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: smohamed141583@nyumc.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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1215377106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22218 93RD RD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281936",
            "telephone_number": "917-683-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22218 93RD RD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281936",
            "telephone_number": "917-683-4182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-630-6745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "SAJID",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smohamed141583@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

Verify at the official NPI Registry.