NPIMap

Individual provider Active NPI

Mubdiul Imtiaz Ali, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • New Haven, CT
National Provider Identifier
1548528565
Registry record updated Jan 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
62410 Issued in CT
Practice address
300 Cedar St # S425
New Haven, CT 06519-1612
Phone
(203) 785-3207
NPI assigned
Apr 27, 2012
Last updated
Jan 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 62410 CT Primary
Pulmonary Disease Physician 207RP1001X 62410 CT

Addresses

Primary practice location

300 Cedar St # S425
New Haven, CT 06519-1612

Mailing address

1250 E Marshall St
Pob 980050
Richmond, VA 23298-0050
Phone (973) 972-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151106001846 MA Practitioner - Internal Medicine 3779893599 Reassigns benefits to 1 organization
I20200915002326 NY Practitioner - Critical Care (Intensivists) 3779893599 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harbor View Medical Services PCGroup PAC ID 5092865873, shared by 3 NPIs, 58 clinicians
John T Mather Memorial HospitalGroup PAC ID 1254237753, shared by 6 NPIs, 176 clinicians

Practice addresses (Care Compare)

125 Oakland Ave
Suite 204
Port Jefferson, NY 11777-2130
Phone (631) 734-6090

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Hospital Inpatient Specialists PLLC Multi-Specialty CurrentSince Jul 1, 2015 Accepting new patients
Harbor View Medical Services PC Multi-Specialty CurrentSince Dec 1, 2020 Accepting new patients
John T Mather Memorial Hospital Multi-Specialty Current Accepting new patients
John T. Mather Memorial Hospital Multi-Specialty Current Accepting new patients
John T. Mather Memorial Hospital Multi-Specialty CurrentSince Jul 20, 2020 Accepting new patients
John T Mather Memorial Hospital Multi-Specialty CurrentSince Jul 20, 2020 Accepting new patients
Harbor View Medical Services PC Multi-Specialty CurrentSince Dec 1, 2020 Accepting new patients
John T. Mather Memorial Hospital Multi-Specialty Current Accepting new patients
John T Mather Memorial Hospital Multi-Specialty Current Accepting new patients
John T. Mather Memorial Hospital Multi-Specialty Past Accepting new patients

Locations

290 Littleton Rd
Unit 3
Chelmsford, MA 01824
Phone (978) 258-4734

41 Highland Ave
Winchester, MA 01890
Phone (781) 756-2000

100 Highlands Blvd
#9
Port Jefferson, NY 11777
Phone (631) 686-7809

125 Oakland Ave
Ste 204
Port Jefferson, NY 11777
Phone (631) 686-1414

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

75 N Country Rd
Ste 201
Prt Jefferson, NY 11777
Phone (631) 686-2575

1 Harbison Way
Ste 222
Columbia, SC 29212

Networks

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

Interoperability endpoints

  • Direct secure messaging: mubdiul.ali.1@8551.direct.athenahealth.com
  • Direct secure messaging: mubdiul.ali@xdr.hhchealthdirect.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579910400000",
    "number": "1548528565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "address_2": "POB 980050",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980050",
            "telephone_number": "973-972-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CEDAR ST # S425",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191612",
            "telephone_number": "203-785-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "MUBDIUL",
        "middle_name": "IMTIAZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-27",
        "last_updated": "2020-01-25",
        "certification_date": "2020-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": "62410",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "62410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.