Individual provider Active NPI

Mahabub Rahman, MD

  • Internal Medicine Physician
  • Maspeth, NY
National Provider Identifier
1275192957
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
100714-01 Issued in NY
Practice address
6995 Queens Midtown Expy
Maspeth, NY 11378-1922
Phone
(718) 429-2200
Fax
(718) 898-7582
NPI assigned
Jun 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 100714-01 NY Primary

Addresses

Primary practice location

6995 Queens Midtown Expy
Maspeth, NY 11378-1922

Mailing address

6136 170TH St Apt M4
Fresh Meadows, NY 11365-1957
Phone (646) 372-0870

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240912003579 CA Practitioner - Family PracticePractitioner - Internal Medicine 7214263920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

26877 Tourney Rd
Santa Clarita, CA 91355-1846
Phone (888) 778-5000

27107 Tourney Rd
Santa Clarita, CA 91355-1860
Phone (661) 222-2323

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 30, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 30, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Aaron Quamina, MD PLLC Internal Medicine PastSince Jun 16, 2019 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

1690 Barton Rd
Ste 104
Redlands, CA 92373
Phone (909) 335-0200

438 W Las Tunas Dr
San Gabriel, CA 91776
Phone (626) 289-5454

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Organizations & group practices 6

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": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1275192957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6136 170TH ST APT M4",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651957",
            "telephone_number": "646-372-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6995 QUEENS MIDTOWN EXPY",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113781922",
            "telephone_number": "718-429-2200",
            "fax_number": "718-898-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "MAHABUB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "100714-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maspeth, NY

Sources for this page

Verify at the official NPI Registry.