NPIMap

Individual provider Active NPI

Tabinda Mirza

  • Physician Assistant
  • East Meadow, NY
National Provider Identifier
1245945765
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2310 Hempstead Tpke
East Meadow, NY 11554-2035
Phone
(516) 346-5090
NPI assigned
Jan 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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 NY Primary

Addresses

Primary practice location

2310 Hempstead Tpke
East Meadow, NY 11554-2035

Mailing address

967 Smithtown Ave
Bohemia, NY 11716-3808
Phone (631) 782-7321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230424000700 NY Practitioner - Physician Assistant 6002271244 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
029661NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Island Urgent Care PLLC CurrentSince Jan 22, 2023 Accepting new patients
State of New York Comptrollers Office CurrentSince May 27, 2023 Accepting new patients
State of New York Comptrollers Office CurrentSince May 27, 2023 Accepting new patients
Chenango Memorial Hospital, Inc. Physician Assistant Past Accepting new patients
A.P. New York Comprehensive Medical Care PC PastSince Jan 22, 2023 Accepting new patients

Locations

2310 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 346-5090

100 Patriots Rd
Stony Brook, NY 11790
Phone (631) 444-8500

Networks

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

Interoperability endpoints

  • Direct secure messaging: urgentcareofny.tabindamirza@156424.advancedmd-direct.com

Organizations & group practices 12

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": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1245945765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 SMITHTOWN AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117163808",
            "telephone_number": "631-782-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542035",
            "telephone_number": "516-346-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "TABINDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.