Individual provider Active NPI

Abdul G Mundia, MD

  • Hematology & Oncology Physician
  • Rockville Centre, NY
National Provider Identifier
1669672101
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
119258 Issued in NY
Practice address
2000 N Village Ave
Suite 405
Rockville Centre, NY 11570-1078
Phone
(516) 763-1962
Fax
(516) 764-0060
NPI assigned
Jul 23, 2007
Last updated
Jul 23, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 119258 NY Primary

Addresses

Primary practice location

2000 N Village Ave
Suite 405
Rockville Centre, NY 11570-1078

Mailing address

2000 N Village Ave
Suite 405
Rockville Centre, NY 11570-1078
Phone (516) 763-1962

Other identifiers 1

IdentifierTypeStateIssuer
00398614MedicaidNY

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
I20050224000588 NY Practitioner - Hematology/OncologyPractitioner - Internal Medicine 0547213050

National Provider Directory

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1669672101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N VILLAGE AVE",
            "address_2": "SUITE 405",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701078",
            "telephone_number": "516-763-1962",
            "fax_number": "516-764-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N VILLAGE AVE",
            "address_2": "SUITE 405",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701078",
            "telephone_number": "516-763-1962",
            "fax_number": "516-764-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDIA",
        "first_name": "ABDUL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "119258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00398614",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.