NPIMap

Individual provider Active NPI

Mohammed N Imam, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Staten Island, NY
National Provider Identifier
1407892292
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
285039 Issued in NY
Practice address
501 Seaview Ave
Suite 202
Staten Island, NY 10305-3419
Phone
(718) 226-6201
Fax
(718) 226-1563
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 285039 NY Primary

Addresses

Primary practice location

501 Seaview Ave
Suite 202
Staten Island, NY 10305-3419

Mailing address

501 Seaview Ave
Suite 202
Staten Island, NY 10305-3419
Phone (718) 226-6201

Other identifiers 1

IdentifierTypeStateIssuer
64050214MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mimam527038@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161109001599 NY Practitioner - Thoracic SurgeryPractitioner - General Surgery 5395714992 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

1300 Franklin Ave
Suite ML2
Garden City, NY 11530-1760
Phone (516) 663-4400

Hospital & facility affiliations

  • NYU Langone Home Health Care Home health agency, Garden City, NY, CCN 337187
  • VNS & Hospice of Suffolk Inc Chha Home health agency, Northport, NY, CCN 337014
  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)45
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Cardiothoracic Surgical Associates Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Sep 30, 2004 Accepting new patients
New York University CurrentSince Oct 1, 2022 Accepting new patients
Physicians of University Hospital, PC CurrentSince Sep 12, 2016 Accepting new patients
New York University CurrentSince Oct 1, 2022 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jun 1, 2019 Accepting new patients
Physicians of University Hospital, PC CurrentSince Sep 12, 2016 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

350 Hospital Way
Ste 220
Somerset, KY 42503
Phone (606) 451-0300

100 Hospital Rd
Ste 115
East Patchogue, NY 11772
Phone (631) 228-5830

1300 Franklin Ave
Ste ML2
Garden City, NY 11530

1401 Franklin Ave
Garden City, NY 11530
Phone (516) 541-0300

300 Community Dr
Plandome, NY 11030

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

1279 E Main St
Riverhead, NY 11901
Phone (631) 727-2100

501 Seaview Ave
Ste 202
Staten Island, NY 10305
Phone (718) 226-6110

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

501 Seaview Ave
Staten Island, NY 10305
Phone (718) 667-4700

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: mohammedimam@nslijmedgr.allscriptsdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1407892292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SEAVIEW AVE",
            "address_2": "SUITE 202",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053419",
            "telephone_number": "718-226-6201",
            "fax_number": "718-226-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SEAVIEW AVE",
            "address_2": "SUITE 202",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053419",
            "telephone_number": "718-226-6201",
            "fax_number": "718-226-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMAM",
        "first_name": "MOHAMMED",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "285039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64050214",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mimam527038@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "1300 Franklin Ave Ste Ml2",
            "city": "Garden City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115301760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.