Individual provider Active NPI

Mohammed Nizam, MD

  • Gynecology Physician
  • New York, NY
National Provider Identifier
1407895089
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
170248 Issued in NY
Practice address
950 Park Ave
New York, NY 10028-0320
Phone
(212) 861-1400
Fax
(631) 953-0019
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 170248 NY Primary

Addresses

Primary practice location

950 Park Ave
New York, NY 10028-0320

Mailing address

950 Park Ave
New York, NY 10028-0320
Phone (212) 861-1400

Other identifiers 1

IdentifierTypeStateIssuer
01501720MedicaidNY

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
I20040428001151 NY Practitioner - Obstetrics/Gynecology 5294722591 Reassigns benefits to 3 organizations
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 Park Ave
New York, NY 10128-1234
Phone (212) 861-1400

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119
  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170248NYMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TJH Medical Services, P.C. CurrentSince Jan 7, 2018 Accepting new patients
Harlem Medical Associates PC CurrentSince Jun 11, 2012 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
Comprehensive Women'S Medicine PLLC Past Accepting new patients
North General Physician Services PLLC PastSince Jul 1, 2006 Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

14601 45th Ave
Fl 2
Flushing, NY 11355
Phone (718) 670-5515

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Interoperability endpoints

  • Direct secure messaging: mnizam67347@northwell.direct-ci.com
  • Direct secure messaging: mnizam680154@nychhc.direct-ci.com

Organizations & group practices 5

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1407895089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280320",
            "telephone_number": "212-861-1400",
            "fax_number": "631-953-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280320",
            "telephone_number": "212-861-1400",
            "fax_number": "631-953-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIZAM",
        "first_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "170248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01501720",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.