Individual provider Active NPI

Mohammad Arshad Mir, M.D.

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1508939190
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
185231 Issued in NY
Practice address
365 Stockholm St
Brooklyn, NY 11237-4005
Phone
(718) 366-4460
Fax
(718) 366-8444
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 185231 NY Primary

Addresses

Primary practice location

365 Stockholm St
Brooklyn, NY 11237-4005

Mailing address

20 Millay Rd
Morganville, NJ 07751-1457
Phone (718) 963-7117

Other identifiers 2

IdentifierTypeStateIssuer
00G462OtherNYBLUE CROSS BLUE SHIELD
01252368MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130412000207 NY Practitioner - Pediatric Medicine 9638315815 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185231NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TBHC Pediatric Services PC Pediatrics CurrentSince Oct 3, 2013 Accepting new patients
Children'S Medical Group Pediatrics Past Accepting new patients
Wyckoff Medical Services, P C Past Accepting new patients

Locations

1280 DeKalb Ave
Brooklyn, NY 11221
Phone (718) 455-9000

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

Networks

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

Interoperability endpoints

  • Direct secure messaging: mmir8751@prd.direct.tbh.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508939190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MILLAY RD",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511457",
            "telephone_number": "718-963-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374005",
            "telephone_number": "718-366-4460",
            "fax_number": "718-366-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIR",
        "first_name": "MOHAMMAD",
        "middle_name": "ARSHAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "185231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00G462",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01252368",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.