Individual provider Active NPI

Sobia Hussain, MS, PA-C

  • Medical Physician Assistant
  • Bronx, NY
National Provider Identifier
1376974279
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
017170 Issued in NY
Practice address
1825 Eastchester Rd
2-76
Bronx, NY 10461-2301
Phone
(718) 904-2000
NPI assigned
Dec 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 017170 NY Primary

Addresses

Primary practice location

1825 Eastchester Rd
2-76
Bronx, NY 10461-2301

Mailing address

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190424002049 NY Practitioner - Physician Assistant 1254673148 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
017170NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince Mar 16, 2019 Accepting new patients
Urban Health Plan, Inc. CurrentSince Mar 16, 2019 Accepting new patients

Locations

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

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": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1376974279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 EASTCHESTER RD",
            "address_2": "2-76",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612301",
            "telephone_number": "718-904-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "SOBIA",
        "credential": "MS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.