Individual provider Active NPI

Rezve Karim

  • Physician Assistant
  • New York, NY
National Provider Identifier
1578107546
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028203 Issued in NY
Practice address
1468 Madison Ave
New York, NY 10029-6508
Phone
(212) 241-2377
NPI assigned
Nov 4, 2019
Last updated
May 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 028203 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1468 Madison Ave
New York, NY 10029-6508

Mailing address

4706 45TH St Apt C1
Woodside, NY 11377-6411
Phone (718) 696-9522

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221221002274 NY Practitioner - Physician Assistant 2769852417 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
028203NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 2, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 2, 2022 Accepting new patients

Locations

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1010 N Broadway
Yonkers, NY 10701
Phone (914) 968-3535

Networks

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1578107546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4706 45TH ST APT C1",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113776411",
            "telephone_number": "718-696-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARIM",
        "first_name": "REZVE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-04",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028203",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.