Active NPI
Jahidul Abedin, MD
- Pediatrics Physician
- Jackson Heights, NY
National Provider Identifier
1407012677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 255429
- Practice address
- 7036 Broadway
Jackson Heights, NY 11372-6113 - Phone
- (718) 313-0822
- Fax
- (631) 546-7515
- NPI assigned
- Aug 6, 2008
- Last updated
- Dec 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 255429 | NY | Primary |
Addresses
Primary practice location
7036 Broadway
Jackson Heights, NY 11372-6113
Mailing address
1 Executive CT
Dix Hills, NY 11746-5003
Phone (718) 313-0822
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03187895 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Legal Medicine
- Jackson Heights, NY
- NPI 1700108156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1407012677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EXECUTIVE CT",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117465003",
"telephone_number": "718-313-0822",
"fax_number": "631-546-7515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7036 BROADWAY",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113726113",
"telephone_number": "718-313-0822",
"fax_number": "631-546-7515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABEDIN",
"first_name": "JAHIDUL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-06",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "255429",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03187895",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.