Individual provider Active NPI

Mizanur Rahman Ahmed, MD

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1265967228
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
300284 Issued in NY
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(212) 263-5506
NPI assigned
Apr 27, 2017
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Student in an Organized Health Care Education/Training Program 390200000X 300284 NY
Anesthesiology Physician 207L00000X 300284 NY Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

50 New York Ave # 25a
Smithtown, NY 11787-3448
Phone (718) 226-9000

Other practice location 1

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000 ext. 69000

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
I20210920001382 NY Practitioner - Anesthesiology 0547667420 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suffolk Anesthesiology Associates PCGroup PAC ID 6204725740, 78 clinicians

Practice addresses (Care Compare)

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300284NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Suffolk Anesthesiology Associates, PC Single Specialty CurrentSince Jun 16, 2021 Accepting new patients
Office Based Anesthesia LLC Single Specialty CurrentSince Sep 15, 2021 Accepting new patients

Locations

185 Central Ave
Bethpage, NY 11714
Phone (516) 733-7100

2112 Middle Country Rd
Centereach, NY 11720
Phone (631) 247-7463

28 Research Way
East Setauket, NY 11733
Phone (631) 380-2710

340 Broadhollow Rd
Farmingdale, NY 11735
Phone (516) 931-0041

975 Stewart Ave
Garden City, NY 11530
Phone (516) 222-8600

70 Glen St
Ste 106
Glen Cove, NY 11542
Phone (516) 759-5330

488 Great Neck Rd
Great Neck, NY 11021
Phone (516) 466-1151

125 Kennedy Dr
Ste 300
Hauppauge, NY 11788
Phone (934) 223-4500

400 Townline Rd
Hauppauge, NY 11788
Phone (631) 360-0266

400 Townline Rd
Ste 135
Hauppauge, NY 11788
Phone (631) 360-0266

200 Old Country Rd
Mineola, NY 11501
Phone (516) 408-4900

59 Southern Blvd
Nesconset, NY 11767
Phone (631) 628-5000

61 Southern Blvd
Nesconset, NY 11767
Phone (516) 222-8610

1991 Marcus Ave
Ste 1010
New Hyde Park, NY 11042
Phone (631) 360-4000

131 Merrick Rd
North Merrick, NY 11566
Phone (516) 223-1515

1991 Marcus Ave
North New Hyde Park, NY 11042
Phone (516) 200-0025

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

889 E Main St
Ste 308
Riverhead, NY 11901
Phone (631) 386-3500

373 Route 111
Ste 7
Smithtown, NY 11787
Phone (631) 360-4000

48 Route 25A
Ste 105
Smithtown, NY 11787
Phone (631) 360-4000

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1265967228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 NEW YORK AVE # 25A",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873448",
            "telephone_number": "718-226-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-9000 x69000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MIZANUR",
        "middle_name": "RAHMAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-27",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "300284",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "300284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.