Individual provider Active NPI

Iqbal Tak, MD

  • Infectious Disease Physician
  • Richmond Hill, NY
National Provider Identifier
1639197486
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
195390 Issued in NY
Practice address
8561 111TH St
Richmond Hill, NY 11418-1638
Phone
(718) 869-6882
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 195390 NY Primary

Addresses

Primary practice location

8561 111TH St
Richmond Hill, NY 11418-1638

Mailing address

8561 111TH St
Richmond Hill, NY 11418-1638
Phone (718) 869-6882

Other identifiers 1

IdentifierTypeStateIssuer
01889665MedicaidNY

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
I20070417000103 NY Practitioner - Infectious DiseasePractitioner - Internal Medicine 0941305197 Practice locations: Flushing, NY; Richmond Hill, NY; Forest Hills, NY

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-2000

8561 111TH St
Richmond Hill, NY 11418-1638
Phone (718) 846-5813

Hospital & facility affiliations

  • Flushing Hospital Medical Center Hospital, Flushing, NY, CCN 330193
  • New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
195390NYMDInfectious Disease Physician

Interoperability endpoints

  • Direct secure messaging: ist9008@direct.nyp.org

Hospital & facility affiliations 6

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1639197486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8561 111TH ST",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114181638",
            "telephone_number": "718-869-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8561 111TH ST",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114181638",
            "telephone_number": "718-869-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAK",
        "first_name": "IQBAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "195390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01889665",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.