Active NPI
Mohammad Andalib, M.D
- Anesthesiology Physician
- Flushing, NY
National Provider Identifier
1447660642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 25MA10667000
- Practice address
- 5645 Main St
Flushing, NY 11355-5045 - Phone
- (718) 670-1572
- NPI assigned
- Apr 28, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 25MA10667000 | NJ | Primary |
Addresses
Primary practice location
5645 Main St
Flushing, NY 11355-5045
Mailing address
5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-1572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210528001805 | NJ | Practitioner - Anesthesiology | 5799184453 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Maryland School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
30 Prospect Ave
Hackensack, NJ 07601-1914
Phone (201) 488-0066
Hospital & facility affiliations
- Hackensack University Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey Healthcare Specialists PC | Anesthesiology | Current | Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Hackensack, NJ
- NPI 1174585780
Anesthesiology, NJ
Hospital & facility affiliations 2
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": "1398643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654732800000",
"number": "1447660642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5645 MAIN ST",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113555045",
"telephone_number": "718-670-1572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5645 MAIN ST",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113555045",
"telephone_number": "718-670-1572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDALIB",
"first_name": "MOHAMMAD",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-28",
"last_updated": "2022-06-09",
"certification_date": "2022-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NJ",
"license": "25MA10667000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.