NPIMap

Individual provider Active NPI

Mohammad Mostafa Amin, M.D.

  • Pulmonary Disease Physician
  • Northport, NY
National Provider Identifier
1568439503
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
217753 Issued in NY
Practice address
79 Middleville Rd
111D - Pulmonary Division
Northport, NY 11768-2200
Phone
(631) 261-4400
NPI assigned
Mar 8, 2006
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 217753 NY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 217753 NY
Pulmonary Disease Physician 207RP1001X 217753 NY Primary

Addresses

Primary practice location

79 Middleville Rd
111D - Pulmonary Division
Northport, NY 11768-2200

Mailing address

7 Rose CT
Centereach, NY 11720-1753
Phone (631) 585-0029

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mohammad.amin@direct.stonybrookmedicine.edu Stony Brook University Hospital

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040610001661 NY Practitioner - Sleep MedicinePractitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 5799768669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sleep Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6277

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217753NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation Pulmonary Disease CurrentSince Aug 1, 2009 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Aug 1, 2009 Accepting new patients
Mohammad Mostafa Amin Physician, PLLC Pulmonary Disease CurrentSince Jun 9, 2006 Accepting new patients

Locations

3000 Hempstead Tpke
Ste 407
Levittown, NY 11756

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

100 Nicolls Rd
#13202
Stony Brook, NY 11794

Networks

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

Interoperability endpoints

  • Direct secure messaging: mohammad.amin@direct.stonybrookmedicine.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1568439503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ROSE CT",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117201753",
            "telephone_number": "631-585-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "address_2": "111D - PULMONARY DIVISION",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN",
        "first_name": "MOHAMMAD",
        "middle_name": "MOSTAFA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "217753",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "217753",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "217753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mohammad.amin@direct.stonybrookmedicine.edu",
            "affiliation": "Y",
            "affiliationName": "Stony Brook University Hospital",
            "address_1": "Nicolls road",
            "address_2": "HSC T12 Room 020 Stony Brook University Hospital",
            "city": "Stony Brook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117948121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Northport, NY

Sources for this page

Verify at the official NPI Registry.