Individual provider Active NPI

Anam Iftikhar Chouhdry, M.D.

  • Diagnostic Radiology Physician
  • Stony Brook, NY
National Provider Identifier
1588196935
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
315338 Issued in NY
Practice address
HSC Level 4, Room 120
101 Nicolls Road
Stony Brook, NY 11794-8460
Phone
(631) 638-2121
Fax
(631) 638-2323
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 315338 NY Primary

Addresses

Primary practice location

HSC Level 4, Room 120
101 Nicolls Road
Stony Brook, NY 11794-8460

Mailing address

HSC Level 4 Room 120
101 Nicolls Road
Stony Brook, NY 11794-8460
Phone (631) 638-2121

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
I20240402003228 NY Practitioner - Diagnostic Radiology 2365797420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-3407
Phone (631) 638-2121

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5400

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 477-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
315338NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Radiology, University Faculty Practice Corporation Diagnostic Radiology CurrentSince Mar 1, 2024 Accepting new patients

Locations

101 Nicolls Rd
Rm 120
Stony Brook, NY 11794
Phone (631) 444-7538

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

Organizations & group practices 1

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 7

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1588196935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HSC LEVEL 4 ROOM 120",
            "address_2": "101 NICOLLS ROAD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948460",
            "telephone_number": "631-638-2121",
            "fax_number": "631-638-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HSC LEVEL 4, ROOM 120",
            "address_2": "101 NICOLLS ROAD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948460",
            "telephone_number": "631-638-2121",
            "fax_number": "631-638-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUHDRY",
        "first_name": "ANAM",
        "middle_name": "IFTIKHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "315338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.