Individual provider Active NPI

MD Abul Hussain

  • Internal Medicine Physician
  • Roslyn Heights, NY
National Provider Identifier
1417680240
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P115535 Issued in NY
Practice address
255 Warner Ave # R
Roslyn Heights, NY 11577-1000
Phone
(212) 729-3923
NPI assigned
Jul 8, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P115535 NY Primary

Addresses

Primary practice location

255 Warner Ave # R
Roslyn Heights, NY 11577-1000

Mailing address

2181 Starling Ave Apt 6a
Bronx, NY 10462-4354

Other identifiers 1

IdentifierTypeStateIssuer
115535OtherNYINTERNAL MEDICINE

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
I20230118002389 NY Practitioner - Internal Medicine 1850762477 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P115535NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nys Medical Associate PLLC Internal Medicine CurrentSince Aug 16, 2023 Accepting new patients
NPI 1770780926 CurrentSince Dec 28, 2022 Accepting new patients
Mill Basin Medical Health PC Internal Medicine CurrentSince Sep 5, 2024 Accepting new patients

Locations

257 State St
Batavia, NY 14020
Phone (585) 343-1300

1583 E 66th St
#1
Brooklyn, NY 11234
Phone (917) 318-4724

48 Frost Ln
Unit A
Lawrence, NY 11559
Phone (516) 587-9960

300 Community Dr
Plandome, NY 11030

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1417680240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 STARLING AVE APT 6A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104624354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 WARNER AVE # R",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771000",
            "telephone_number": "212-729-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "MD",
        "middle_name": "ABUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P115535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL MEDICINE",
            "identifier": "115535",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

Verify at the official NPI Registry.