Mid Island Medical PC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

234347 Issued in NY

Legal business name

MID ISLAND MEDICAL PC

Practice address

285 Sills Rd
East Patchogue, NY 11772-4869

Phone

(631) 618-9030

NPI assigned

May 9, 2018

Organization subpart

No

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

Authorized official

Name

Musarrat Iqbal, MDNPI 1558441584

Title

Physician

Phone

(631) 618-9030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Musarrat Iqbal, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • East Patchogue, NY
  • NPI 1558441584
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1356830954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-618-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-618-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ISLAND MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "IQBAL",
        "authorized_official_first_name": "MUSARRAT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-618-9030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NY",
            "license": "234347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Arthur Merriam, DDS
• Nancy Anne Meyers, LPN
• Maria Jean Mezzatesta
• Daniel Michaels, ATC
• Michele Rauer Physical Therapy Assistant, P.C.
• Janice Mierisch, LPN
• Jeremy Paul Mierisch, L.AC,,MS
• Jill M Migdol, MSED
• Mikhail Grzhibek, M.D., P.C.
• Ellyn Dawn Milia, RN

• Pain Clinic/Center in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Pain Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.