Individual provider Active NPI

Reza Ghavamian, MD

  • Urology Physician
  • Bronx, NY
National Provider Identifier
1548376171
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
210371 Issued in NY
Practice address
MMC - Dept of Urology
3400 Bainbridge Avenue, 5TH FL
Bronx, NY 10467
Phone
(718) 920-8475
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

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
Urology Physician 208800000X 210371 NY Primary

Addresses

Primary practice location

MMC - Dept of Urology
3400 Bainbridge Avenue, 5TH FL
Bronx, NY 10467

Mailing address

47 Sagamore Rd
Bronxville, NY 10708-1557
Phone (718) 920-8475

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
I20071220000648 NY Practitioner - Urology 3971693482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Boston University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

27005 76TH Ave
Mhg069
New Hyde Park, NY 11040-1402
Phone (718) 470-7848

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection32
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 1, 2006 Accepting new patients
Montefiore Medical Center Urology CurrentSince Jan 1, 2006 Accepting new patients
North Shore-Lij Medical PC Urology CurrentSince Aug 25, 2018 Accepting new patients
Huntington Hospital Association Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

18 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 693-1660

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: rezaghavamian@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548376171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 SAGAMORE RD",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107081557",
            "telephone_number": "718-920-8475",
            "fax_number": "718-547-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - DEPT OF UROLOGY",
            "address_2": "3400 BAINBRIDGE AVENUE, 5TH FL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAVAMIAN",
        "first_name": "REZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "210371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.