Individual provider Active NPI

Hamza Pervaiz, MD

  • Internal Medicine Physician
  • South Richmond Hill, NY
National Provider Identifier
1366171845
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
340829 Issued in NY
Practice address
11616 Liberty Ave
South Richmond Hill, NY 11419-1941
Phone
(718) 641-1117
Fax
(718) 756-1390
NPI assigned
Jun 9, 2022
Last updated
Dec 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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 340829 NY Primary

Addresses

Primary practice location

11616 Liberty Ave
South Richmond Hill, NY 11419-1941

Mailing address

10 Harbor CT E
Roslyn, NY 11576-2435
Phone (929) 484-1236

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251209003339 NY Practitioner - Internal Medicine 6901390871 Reassigns benefits to 1 organization
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Harbor CT E
Roslyn, NY 11576-2435

11616 Liberty Ave
South Richmond Hill, NY 11419-1941

1836 Amsterdam Ave
New York, NY 10031-1715
Phone (718) 641-1117

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hamza Pervaiz Physician PC Internal Medicine CurrentSince Apr 1, 2026 Accepting new patients
Crown Heights Medical Doctor PC CurrentSince Dec 1, 2025 Accepting new patients

Locations

1135 Eastern Pkwy
Brooklyn, NY 11213
Phone (718) 756-1309

1836 Amsterdam Ave
New York, NY 10031
Phone (718) 641-1117

Interoperability endpoints

  • Direct secure messaging: jig9038@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, 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": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1366171845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HARBOR CT E",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762435",
            "telephone_number": "929-484-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11616 LIBERTY AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191941",
            "telephone_number": "718-641-1117",
            "fax_number": "718-756-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERVAIZ",
        "first_name": "HAMZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "340829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.