Individual provider Active NPI

Mina Botros

  • Endocrinology, Diabetes & Metabolism Physician
  • Flushing, NY
National Provider Identifier
1477040186
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MA11266000 Issued in NJ
Practice address
4500 Parsons Blvd
Flushing, NY 11355-2205
Phone
(718) 844-8162
NPI assigned
Apr 18, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA11266000 NJ Primary

Addresses

Primary practice location

4500 Parsons Blvd
Flushing, NY 11355-2205

Mailing address

125 Paterson St FL 5
New Brunswick, NJ 08901-1962
Phone (718) 844-8162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211102002177 NJ Practitioner - Internal Medicine 0244575355 Reassigns benefits to 3 organizations
I20231023000526 NY Practitioner - Endocrinology 0244575355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1723 N Ocean Ave
Medford, NY 11763-2687
Phone (631) 758-5858

Hospital & facility affiliations

  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
323182NYMDLicensed Practical Nurse
25MA11266000NJMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Jan 1, 2022 Accepting new patients
North Shore - Lij Medical PC CurrentSince Aug 31, 2023 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Jan 1, 2022 Accepting new patients
Sai Inpatient Resources, LLC CurrentSince Nov 20, 2021 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 31, 2023 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC CurrentSince Oct 8, 2022 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

125 Paterson St
Fl 5
New Brunswick, NJ 08901
Phone (732) 235-6561

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

1723 N Ocean Ave
Medford, NY 11763
Phone (631) 758-5858

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: minabotros@nslijmedgr.allscriptsdirect.net

Organizations & group practices 6

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": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1477040186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST FL 5",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "718-844-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARSONS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552205",
            "telephone_number": "718-844-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTROS",
        "first_name": "MINA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA11266000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.