Active NPI
Mosammat Ireen Alam
- Physician Assistant
- Jamaica, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 029702-01
- Practice address
- 9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001 - Phone
- (718) 262-2000
- NPI assigned
- Feb 15, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 029702-01 | NY | Primary |
Addresses
Primary practice location
9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001
Mailing address
9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3733 82ND St
Jackson Heights, NY 11372-7031
Phone (646) 604-8190
4426 18TH Ave
Brooklyn, NY 11204-1201
Phone (718) 635-9700
6122 Fresh Pond Rd
Middle Village, NY 11379-1040
Phone (718) 502-3000
6402 108TH St
Forest Hills, NY 11375-1604
Phone (212) 734-6621
6721 Fresh Pond Rd
Ridgewood, NY 11385-4562
Phone (929) 468-9920
68 Graham Ave
Brooklyn, NY 11206-4017
Phone (646) 604-8130
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029702 | NY | MD | Physical Therapist |
| 029702-01 | NY | MD | Physician Assistant |
Interoperability endpoints
- dxl9007@direct.nyp.org
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Middle Village, NY
- NPI 1275936932
-
- Urgent Care Clinic/Center
- Brooklyn, NY
- NPI 1932590601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695340800000",
"number": "1316645765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9420 GUY R BREWER BLVD",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114510001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9420 GUY R BREWER BLVD",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114510001",
"telephone_number": "718-262-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALAM",
"first_name": "MOSAMMAT",
"middle_name": "IREEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-15",
"last_updated": "2023-09-22",
"certification_date": "2023-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "029702-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.