Individual provider Active NPI

Mairaj Ud Din, MD

  • Internal Medicine Physician
  • Garden City, NY
National Provider Identifier
1609804319
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42496 Issued in MN
Practice address
800 Axinn Ave
Garden City, NY 11530-2139
Phone
(646) 680-2894
Fax
(516) 542-5556
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42496 MN Primary

Addresses

Primary practice location

800 Axinn Ave
Garden City, NY 11530-2139

Mailing address

441 9TH Ave
Acp-Credemtialing
New York, NY 10001-1623
Phone (646) 680-2894

Other identifiers 1

IdentifierTypeStateIssuer
786187700MedicaidMN

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
I20120724000417 NY Practitioner - Internal Medicine 3577569722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (516) 257-5700

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (516) 257-5700

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 287-5700

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Range Medical Services PastSince Jul 3, 2010 Accepting new patients
The Duluth Clinic, LTD. Past Accepting new patients
North Shore University Hospital Past Accepting new patients
Oak Hill Hospitalist, LLC Internal Medicine Past Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients

Organizations & group practices 6

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 2

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1609804319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 9TH AVE",
            "address_2": "ACP-CREDEMTIALING",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100011623",
            "telephone_number": "646-680-2894",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AXINN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302139",
            "telephone_number": "646-680-2894",
            "fax_number": "516-542-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIN",
        "first_name": "MAIRAJ",
        "middle_name": "UD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "42496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "786187700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.