Organization Active NPI

Pervaiz Iqbal Physician PC

  • Pulmonary Disease Physician
  • Roslyn, NY
National Provider Identifier
1477765469
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PERVAIZ IQBAL PHYSICIAN PC
Practice address
10 E Harbor Court
Roslyn, NY 11576
Phone
(718) 641-1309
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Indra Parboo
Title
Front Office Manager
Phone
(718) 641-1117

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X NY
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X NY Primary

Addresses

Primary practice location

10 E Harbor Court
Roslyn, NY 11576

Mailing address

10 E Harbor Court
Roslyn, NY 11576
Phone (718) 641-1117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120418000482 NY Part B Supplier - Clinic/Group Practice 6204097264 Receives reassigned benefits from 5 practitioners
Practice locations: Plainview, NY; South Richmond Hill, NY; Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

3048 Brighton 1st St
Ste 6
Brooklyn, NY 11235
Phone (718) 676-6416

183 Broadway
Ste 309
Hicksville, NY 11801
Phone (516) 303-0537

512 Old Country Rd
Plainview, NY 11803
Phone (718) 641-1117

514 Old Country Rd
Plainview, NY 11803

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1477765469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E HARBOR COURT",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "718-641-1117",
            "fax_number": "718-756-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E HARBOR COURT",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "718-641-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERVAIZ IQBAL PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "PARBOO",
        "authorized_official_first_name": "INDRA",
        "authorized_official_title_or_position": "FRONT OFFICE MANAGER",
        "authorized_official_telephone_number": "718-641-1117"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.