Individual provider Active NPI

Attia Mahfooz, PA

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1487057212
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0177061 Issued in NY
Practice address
739 Knickerbocker Ave
Brooklyn, NY 11221-5336
Phone
(718) 456-1900
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0177061 NY Primary

Addresses

Primary practice location

739 Knickerbocker Ave
Brooklyn, NY 11221-5336

Mailing address

739 Knickerbocker Ave
Brooklyn, NY 11221-5336
Phone (718) 456-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0177061NYMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1487057212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112215336",
            "telephone_number": "718-456-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112215336",
            "telephone_number": "718-456-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHFOOZ",
        "first_name": "ATTIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "0177061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.