Active NPI
Anum Humayun, MD
- Internal Medicine Physician
- Staten Island, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 317929
- Practice address
- 355 Bard Ave. Dept of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310 - Phone
- (718) 818-2419
- NPI assigned
- Apr 19, 2019
- Last updated
- Jun 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 317929 | NY | Primary |
Addresses
Primary practice location
355 Bard Ave. Dept of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310
Mailing address
355 Bard Ave. Dept of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310
Phone (718) 818-2419
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
355 Bard Ave
Staten Island, NY 10310-1664
4434 Amboy Rd
Staten Island, NY 10312-3845
Phone (718) 984-9658
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 71.48 of 100
- Quality
- 82.91
- Promoting interoperability
- 5.67
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 317929 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amboy Medical Practice PC | Current | Accepting new patients | |
| Amboy Medical Practice PC | Internal Medicine | Current | Accepting new patients |
| Richmond Medical Center | Past | Accepting new patients |
Locations
355 Bard Ave
Bldg 1ST
Staten Island, NY 10310
Phone (718) 720-1222
360 Bard Ave
Lowr
Staten Island, NY 10310
Phone (718) 818-2186
4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Staten Island, NY
- NPI 1700037975
-
- Diagnostic Radiology Physician
- Staten Island, NY
- NPI 1104692672
-
- General Acute Care Hospital
- Staten Island, NY
- NPI 1740389154
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Staten Island, NY
- NPI 1740389154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656201600000",
"number": "1467015966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 BARD AVE. DEPT OF MEDICINE VILLA BLDG 1ST FLOOR",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10310",
"telephone_number": "718-818-2419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 BARD AVE. DEPT OF MEDICINE VILLA BLDG 1ST FLOOR",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10310",
"telephone_number": "718-818-2419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMAYUN",
"first_name": "ANUM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-19",
"last_updated": "2022-06-26",
"certification_date": "2022-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "317929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.