Individual provider Active NPI

Mumtaz Jafri, MD

  • Cardiovascular Disease Physician
  • Staten Island, NY
National Provider Identifier
1366624744
Registry record updated Jun 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
126904-1 Issued in NY
Practice address
1366 Victory Blvd Ste B
Staten Island, NY 10301-3907
Phone
(718) 442-8351
Fax
(718) 442-4073
NPI assigned
Nov 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 126904-1 NY Primary

Addresses

Primary practice location

1366 Victory Blvd Ste B
Staten Island, NY 10301-3907

Mailing address

1366 Victory Blvd Ste B
Staten Island, NY 10301-3907
Phone (718) 442-8351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
126904-1NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samala R Swamy, MD, PC Cardiovascular Disease PastSince Nov 4, 2009 Accepting new patients
Zahir H Rahman MD PLLC Cardiovascular Disease PastSince Nov 1, 2021 Accepting new patients
Bard Cardiology Associates, PC Cardiovascular Disease Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244246400000",
    "number": "1366624744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 VICTORY BLVD STE B",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013907",
            "telephone_number": "718-442-8351",
            "fax_number": "718-442-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 VICTORY BLVD STE B",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013907",
            "telephone_number": "718-442-8351",
            "fax_number": "718-442-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFRI",
        "first_name": "MUMTAZ",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2009-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "126904-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.