Individual provider Active NPI

Riem Badr, M.D.

  • Hematology (Pathology) Physician
  • Port Jefferson Station, NY
National Provider Identifier
1649571407
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Pathology) PhysicianTaxonomy code 207ZH0000X
License
291625 Issued in NY
Practice address
1500 Route 112 BLDG 4
Port Jefferson Station, NY 11776-8055
Phone
(631) 751-3000
Fax
(631) 751-3000
NPI assigned
Nov 10, 2010
Last updated
Mar 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X A91682 CA
Hematology (Pathology) Physician 207ZH0000X 291625 NY Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A91682 CA

Addresses

Primary practice location

1500 Route 112 BLDG 4
Port Jefferson Station, NY 11776-8055

Mailing address

1500 Route 112 BLDG 4
Port Jefferson Station, NY 11776-8055
Phone (631) 751-3000

Other practice location 1

15 Crawford St Ste 100
Needham, MA 02494-2618
Phone (617) 969-4100

Other identifiers 1

IdentifierTypeStateIssuer
05636228MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190404000880 NY Practitioner - Pathology 9830492263 Reassigns benefits to 1 organization
I20220215000172 NJ Practitioner - Pathology 9830492263

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

1500 Route 112
Suite 101
Port Jefferson Station, NY 11776-8054
Phone (631) 751-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A91682CAMDHematology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Apr 18, 2019 Accepting new patients

Locations

201 State Rt 17
Fl 11
Rutherford, NJ 07070
Phone (201) 500-4958

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3538

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1649571407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 BLDG 4",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768055",
            "telephone_number": "631-751-3000",
            "fax_number": "631-751-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 BLDG 4",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768055",
            "telephone_number": "631-751-3000",
            "fax_number": "631-751-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Crawford St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Needham",
            "state": "MA",
            "postal_code": "024942618",
            "country_code": "US",
            "telephone_number": "617-969-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BADR",
        "first_name": "RIEM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "CA",
            "license": "A91682",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "NY",
            "license": "291625",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A91682",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05636228",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.