Abdul-Samad Mirza

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

323388 Issued in NY

Practice address

107 Mitchel Field Way
Garden City, NY 11530-5034

Phone

(631) 813-6869

NPI assigned

Apr 7, 2019

Last updated

Apr 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Interventional Pain Management

Education

New York College of Osteo Medicine of New York Institute of Technology, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pain Physicians Ny PLLCGroup PAC ID 3870779143, 6 clinicians

LR Medical PLLCGroup PAC ID 1052534666, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• LR Medical PLLC

  • Interventional Pain Medicine Physician
  • Brooklyn, NY
  • NPI 1760808802
  Medicare reassignment Care Compare group NPD
• Pain Physicians Ny PLLC

  • Interventional Pain Medicine Physician
  • New York, NY
  • NPI 1538465497
  Medicare reassignment Care Compare group NPD
• Mirza Medical Services PLLC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Floral Park, NY
  • NPI 1689463713
  NPD Authorized official
• LR Medical PLLC

  • Durable Medical Equipment & Medical Supplies
  • Brooklyn, NY
  • NPI 1952290389
  NPD
• Big Leap Medical Group PA

  • Neurological Surgery Physician
  • New York, NY
  • NPI 1821841503
  NPD (past)

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

{
    "created_epoch": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1619430782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MITCHEL FIELD WAY",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305034",
            "telephone_number": "631-813-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MITCHEL FIELD WAY",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305034",
            "telephone_number": "631-813-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "ABDUL-SAMAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-07",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "OS18253",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NY",
            "license": "323388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Elaine Miller, DPT
• Millpond Medical, P.C.
• Lisa Mineo, LMFT, CASAC-T
• Pasquale Minuto, RPH
• Felice J. Mirsky, M.D.
• Christopher S Misciagno, MD
• Kelly Misevich
• Raquel Yvonne Mitchel, DPT
• Keiofia Katasha Mitchell
• Leona Mitchell, RN

• Neuromusculoskeletal Medicine & OMM Physician in Garden City, NY
• Providers in Garden City, NY by specialty
• Neuromusculoskeletal Medicine & OMM Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.