Justin Bruno Mirza, DO

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

258198 Issued in NY

Practice address

51-15 Beach Channel Drive
Peninsula Hospital Center
Far Rockaway, NY 11691

Phone

(718) 734-3020

NPI assigned

Feb 24, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Orthopedic SurgeryAlso: Hand Surgery

Education

New York College of Osteo Medicine of New York Institute of Technology, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Justin Mirza DO PCGroup PAC ID 5597070680, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Catherine of Siena Hospital Hospital, Smithtown, NY, CCN 330401
• St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Justin Mirza D.O. PC

  • Orthopaedic Hand Surgery Physician
  • Smithtown, NY
  • NPI 1508252321
  Medicare reassignment Care Compare group NPD Authorized official

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

• St Charles Hospital Corp

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1164481529
  Care Compare affiliation
• St. Catherine of Siena Medical Center

  • General Acute Care Hospital
  • Smithtown, NY
  • NPI 1982663423
  Care Compare affiliation

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1356648570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51-15 BEACH CHANNEL DRIVE",
            "address_2": "PEINISULA HOSPITAL CENTER",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51-15 BEACH CHANNEL DRIVE",
            "address_2": "PENINSULA HOSPITAL CENTER",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-734-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "JUSTIN",
        "middle_name": "BRUNO",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-24",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "258198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258198",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eveline Milfort, M.S. ED/ TSHH
• Christine Ashley Miller, PA
• Eli Miller, MSW
• Robin Yvette Miller, R.N.
• Yael Miller, SLP
• Devorah Mishler
• Deepah Mishra
• Ashley Mitchell
• Shereen Moffatt-Ukaxchukwu
• Mohsen Mohamed, DPT, PT

• Orthopaedic Surgery Physician in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Orthopaedic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.

Verify at the official NPI Registry.