NPIMap

Organization Active NPI

Masoom H. Qadeer, M.D., P.C.

  • Anesthesiology Physician
  • Deer Park, NY
National Provider Identifier
1487703401
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MASOOM H. QADEER, M.D., P.C.
Practice address
1993 Deer Park Ave
Deer Park, NY 11729-2719
Phone
(631) 242-7246
Fax
(631) 242-4907
NPI assigned
Jan 9, 2007
Last updated
Jan 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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

Authorized official

Name
Masoom H Qadeer, M.D.NPI 1144265760
Title
Owner
Phone
(631) 242-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X

Addresses

Primary practice location

1993 Deer Park Ave
Deer Park, NY 11729-2719

Mailing address

460 Half Hollow Rd
Dix Hills, NY 11746-5829
Phone (631) 242-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070716000472 NY Part B Supplier - Clinic/Group Practice 6709986060 Receives reassigned benefits from 1 practitioner
Practice locations: Deer Park, NY; Shirley, NY; Patchogue, NY

National Provider Directory

National Provider Directory

Locations

20 Grand Ave
Shirley, NY 11967
Phone (631) 281-1890

Practitioners & affiliated clinicians

Practitioners 9

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263772800000",
    "number": "1487703401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 HALF HOLLOW RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465829",
            "telephone_number": "631-242-7246",
            "fax_number": "631-242-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292719",
            "telephone_number": "631-242-7246",
            "fax_number": "631-242-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASOOM H. QADEER, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2010-01-18",
        "status": "A",
        "authorized_official_last_name": "QADEER",
        "authorized_official_first_name": "MASOOM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-242-7246",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.