Active NPI
Shabraiz Rasul, MD
- Internal Medicine Physician
- Nesconset, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 338544
- Practice address
- 59 Southern Blvd
Nesconset, NY 11767-1090 - Phone
- (631) 418-8069
- NPI assigned
- Apr 20, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 338544 | NY | Primary |
Addresses
Primary practice location
59 Southern Blvd
Nesconset, NY 11767-1090
Mailing address
59 Southern Blvd
Nesconset, NY 11767-1090
Phone (631) 418-8069
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560
101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560
Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000
PO Box
Suite 1554
Stony Brook, NY 11790-0989
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 338544 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Internists, University Faculty Practice Corporation | Current | Accepting new patients | |
| Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Current | Accepting new patients |
Locations
240 Meeting House Ln
Southampton, NY 11968
Phone (631) 726-0409
100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
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
- Stony Brook, NY
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- NPI 1295778371
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756857600000",
"number": "1346984911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59 SOUTHERN BLVD",
"city": "NESCONSET",
"state": "NY",
"postal_code": "117671090",
"telephone_number": "631-418-8069",
"fax_number": "631-656-0470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 SOUTHERN BLVD",
"city": "NESCONSET",
"state": "NY",
"postal_code": "117671090",
"telephone_number": "631-418-8069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RASUL",
"first_name": "SHABRAIZ",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-20",
"last_updated": "2025-09-03",
"certification_date": "2025-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "338544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nesconset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.