Individual provider Active NPI

Ummul Wara Masud, , MD

  • Student in an Organized Health Care Education/Training Program
  • Corpus Christi, TX
National Provider Identifier
1376222968
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3533 S Alameda St
Corpus Christi, TX 78411-1721
Phone
(361) 694-5465
NPI assigned
Jul 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P122086 NY
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3533 S Alameda St
Corpus Christi, TX 78411-1721

Mailing address

600 Barwood Park
Austin, TX 78753-6476
Phone (208) 760-2397

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
I20240119001339 NY Practitioner - Internal Medicine 0840642476 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P122086NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Basin Medical Health PC Internal Medicine CurrentSince Apr 2, 2024 Accepting new patients
Nys Medical Associate PLLC Internal Medicine CurrentSince Nov 27, 2023 Accepting new patients

Locations

1583 E 66th St
#1
Brooklyn, NY 11234
Phone (917) 318-4724

99 6th Ave
Ilion, NY 13357
Phone (315) 895-4050

48 Frost Ln
Unit A
Lawrence, NY 11559
Phone (516) 587-9960

300 Community Dr
Plandome, NY 11030

28652 State Highway 23
Stamford, NY 12167
Phone (607) 652-7521

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1376222968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BARWOOD PARK",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787536476",
            "telephone_number": "208-760-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "361-694-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASUD",
        "first_name": "UMMUL WARA",
        "credential": ", MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P122086",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.