Individual provider Active NPI

Junaid Mundiya, D.M.D.

  • Student in an Organized Health Care Education/Training Program
  • Brooklyn, NY
National Provider Identifier
1447631445
Registry record updated Mar 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
NONE Issued in NY
Practice address
155 Ashland PL Dept of
Brooklyn, NY 11201
Phone
(718) 250-8616
NPI assigned
Jun 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019030361 IL
Student in an Organized Health Care Education/Training Program 390200000X NONE NY Primary

Addresses

Primary practice location

155 Ashland PL Dept of
Brooklyn, NY 11201

Mailing address

86 Murray Hill St FL 2
Elmont, NY 11003-2126
Phone (516) 589-0239

Other practice location 1

2605 S Indiana Ave
Unit 2409
Chicago, IL 60616-2849
Phone (516) 589-0239

Other practice location 2

800 Poly Pl
Brooklyn, NY 11209-7104
Phone (718) 836-6600

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220913002420 NY Practitioner - Oral Surgery 3678810876 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019030361ILMDDentist
061809NYMDPharmacist
NONENYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
St. Barnabas Hospital CurrentSince Aug 1, 2022 Accepting new patients
St. Barnabas Hospital Dentist CurrentSince Aug 1, 2022 Accepting new patients
Union Community Health Center, Inc. CurrentSince Jul 1, 2022 Accepting new patients

Locations

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

Networks

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

Interoperability endpoints

  • Direct secure messaging: jmundiya19266@sbhny.direct-ci.net

Organizations & group practices 3

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": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552780800000",
    "number": "1447631445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 MURRAY HILL ST FL 2",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032126",
            "telephone_number": "516-589-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 ASHLAND PL DEPT OF",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11201",
            "telephone_number": "718-250-8616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2605 S Indiana Ave",
            "address_2": "Unit 2409",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606162849",
            "country_code": "US",
            "telephone_number": "516-589-0239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Poly Pl",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112097104",
            "country_code": "US",
            "telephone_number": "718-836-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNDIYA",
        "first_name": "JUNAID",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2019-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030361",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "NONE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.