Individual provider Active NPI

Ashfaqur R Choudhury, MD

  • Pediatrics Physician
  • Staten Island, NY
National Provider Identifier
1366904088
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
317906 Issued in NY
Practice address
4771 Hylan Blvd
Staten Island, NY 10312-6315
Phone
(718) 948-8200
Fax
(718) 317-4111
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 317906 NY Primary

Addresses

Primary practice location

4771 Hylan Blvd
Staten Island, NY 10312-6315

Mailing address

55 Water Street
2ND Floor Cred Dept
New York, NY 10041-0010
Phone (646) 680-2888

Other practice location 1

1050 Clove Road
Staten Island, NY 10301-3627
Phone (718) 816-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220923000379 NY Practitioner - Pediatric Medicine 1951786169 Reassigns benefits to 2 organizations
I20241015002356 NJ Practitioner - Pediatric Medicine 1951786169 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Oct 24, 2022 Accepting new patients
Advantagecare Physicians PC CurrentSince Oct 24, 2022 Accepting new patients
Newark Community Health Centers, Inc. Current Accepting new patients
Newark Community Health Centers, Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

101 Ludlow St
Newark, NJ 07114
Phone (973) 565-0355

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

55 Water St
Fl 2
New York, NY 10041

4771 Hylan Blvd
Staten Island, NY 10312
Phone (718) 948-8200

1050 Clove Rd
Staten Island, NY 10301
Phone (718) 816-6440

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA
  • Direct secure messaging: ashfaqur.choudhury@hrh.eclinicaldirectplus.com
  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 5

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1366904088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER STREET",
            "address_2": "2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410010",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4771 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126315",
            "telephone_number": "718-948-8200",
            "fax_number": "718-317-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Clove Road",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103013627",
            "country_code": "US",
            "telephone_number": "718-816-6440",
            "fax_number": "718-420-2718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOUDHURY",
        "first_name": "ASHFAQUR",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "317906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.