Individual provider Active NPI

Tariq Waseem, M.D.

  • General Practice Physician
  • Long Island City, NY
National Provider Identifier
1366517930
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
126149 Issued in NY
Practice address
3636 33Rd St Ste 306
Long Island City, NY 11106-2329
Phone
(844) 403-4325
Fax
(424) 625-0010
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 126149 NY Primary

Addresses

Primary practice location

3636 33Rd St Ste 306
Long Island City, NY 11106-2329

Mailing address

3636 33Rd St Ste 306
Long Island City, NY 11106-2329
Phone (844) 403-4325

Other practice location 1

6010 Bay Pkwy Ste 901
Brooklyn, NY 11204-6081
Phone (718) 238-2100

Other identifiers 2

IdentifierTypeStateIssuer
00235447MedicaidNY
126149OtherNYLICENSE

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
I20100120000497 NY Practitioner - General Practice 8123160736 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vantage Medical Associates PCGroup PAC ID 0547673816, 84 clinicians

Practice addresses (Care Compare)

1612 Central Ave
Suite 201
Far Rockaway, NY 11691-4002
Phone (516) 792-1600

Hospital & facility affiliations

  • Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1366517930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 33RD ST STE 306",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111062329",
            "telephone_number": "844-403-4325",
            "fax_number": "424-625-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 33RD ST STE 306",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111062329",
            "telephone_number": "844-403-4325",
            "fax_number": "424-625-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6010 Bay Pkwy Ste 901",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112046081",
            "country_code": "US",
            "telephone_number": "718-238-2100",
            "fax_number": "718-748-0863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASEEM",
        "first_name": "TARIQ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "126149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00235447",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "126149",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.