Individual provider Active NPI

Ali Imran

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1386170322
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
306381 Issued in NY
Practice address
39 Clarkson St
New York, NY 10014-3605
Phone
(845) 270-2676
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 306381 NY Primary

Addresses

Primary practice location

39 Clarkson St
New York, NY 10014-3605

Mailing address

89 Rhodes Dr
New Hyde Park, NY 11040-3527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DC, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220609002438 NY Practitioner - Psychiatry 8123365244 Reassigns benefits to 1 organization
I20230411002682 DC Practitioner - Psychiatry 8123365244 Reassigns benefits to 2 organizations
I20250523001992 VA Practitioner - Psychiatry 8123365244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York Downstate Medical Center, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

150 Riverside Pkwy
Fredericksburg, VA 22406-1094
Phone (833) 351-8255

1775 I St NW
Suite 1150 Talkiatry
Washington, DC 20006-2435
Phone (833) 351-8255

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Jul 26, 2022 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 1, 2023 Accepting new patients

Locations

1775 I St NW
Ste 1150
Washington, DC 20006
Phone (202) 313-7696

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

2800 Eisenhower Ave
Ste 220
Alexandria, VA 22314
Phone (540) 358-0423

150 Riverside Pkwy
Ste 115
Fredericksburg, VA 22406
Phone (540) 530-5545

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1386170322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 RHODES DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 CLARKSON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100143605",
            "telephone_number": "845-270-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMRAN",
        "first_name": "ALI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "306381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.