Individual provider Active NPI

Mehribon Ahadova, FNP

  • Family Nurse Practitioner
  • North Bellmore, NY
National Provider Identifier
1245048669
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355634 Issued in NY
Practice address
17 Davenport PL
North Bellmore, NY 11710-2602
Phone
(718) 864-2806
NPI assigned
Dec 19, 2024
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 355634 NY Primary

Addresses

Primary practice location

17 Davenport PL
North Bellmore, NY 11710-2602

Mailing address

17 Davenport PL
North Bellmore, NY 11710-2602
Phone (718) 864-2806

Other names 1

  • Mehribon Saidmurodova Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250508000439 NY Practitioner - Nurse Practitioner 4385161868 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
De Fazio Obstetrics & Gynecology, PC CurrentSince Mar 1, 2025 Accepting new patients

Locations

1301 82nd St
Brooklyn, NY 11228
Phone (718) 836-3721

1301 82nd St
#26
Brooklyn, NY 11228
Phone (718) 836-3721

90 S 8th St
Brooklyn, NY 11249
Phone (718) 836-3721

Organizations & group practices 1

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": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1245048669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DAVENPORT PL",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117102602",
            "telephone_number": "718-864-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 DAVENPORT PL",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117102602",
            "telephone_number": "718-864-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHADOVA",
        "first_name": "MEHRIBON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEHRIBON",
            "last_name": "SAIDMURODOVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Bellmore, NY

Sources for this page

Verify at the official NPI Registry.