Mahbub Mohammad Bhuiyan, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

P114784 Issued in NY

Practice address

6 Medical PLZ
Glen Cove, NY 11542-2108

Phone

(631) 742-9081

NPI assigned

Apr 12, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1497497176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 GOLFVIEW DR APT 205",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843838",
            "telephone_number": "248-835-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MEDICAL PLZ",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422108",
            "telephone_number": "631-742-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHUIYAN",
        "first_name": "MAHBUB",
        "middle_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "P114784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIMITED PERMIT TO PRACTICE MEDICINE",
            "identifier": "P114784",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Sigmacare",
            "affiliation": "N",
            "address_1": "6 Medical Plz",
            "city": "Glen Cove",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115422108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tavya Benjamin, M.D.
• David Berger, M.D.
• Besarta Berisha, N. P.
• Holly Berns, MD
• BH DME Inc
• Roshni Bisoondial, MD
• Suzanne Paige Blacharski, LCSW
• Black Hall Dental, P.C.
• Rachel Blihar, RD
• Amanda Bodner

• Geriatric Medicine (Internal Medicine) Physician in Glen Cove, NY
• Providers in Glen Cove, NY by specialty
• Geriatric Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.