Active NPI
Mousumi Reja
- Physician Assistant
- South Richmond Hill, NY
National Provider Identifier
1689397747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 029234
- Practice address
- 11220 Liberty Ave
South Richmond Hill, NY 11419-1814 - Phone
- (646) 498-4544
- NPI assigned
- Sep 23, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 1104310440 | NY | |
| Physician Assistant | 363A00000X | 029234 | NY | Primary |
Addresses
Primary practice location
11220 Liberty Ave
South Richmond Hill, NY 11419-1814
Mailing address
9513 120TH St
South Richmond Hill, NY 11419-1307
Phone (347) 752-0053
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1104310440 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694995200000",
"number": "1689397747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9513 120TH ST",
"city": "SOUTH RICHMOND HILL",
"state": "NY",
"postal_code": "114191307",
"telephone_number": "347-752-0053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11220 LIBERTY AVE",
"city": "SOUTH RICHMOND HILL",
"state": "NY",
"postal_code": "114191814",
"telephone_number": "646-498-4544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REJA",
"first_name": "MOUSUMI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-23",
"last_updated": "2023-09-18",
"certification_date": "2023-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "NY",
"license": "1104310440",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "029234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Richmond Hill, NY
- Dropattie Ramsammy
- Sunaina Devi Ravuru, PA
- Redpeak Equipments & Diagnostics LLC
- Dominic Edwin Regalbuto, PHARMD, RPH
- Reginald Hughes, MD PC
- Resolutions Counseling and Family Services LCSW PLLC
- Asi Ressler, O.D.
- Wendy T. Reyes, FNP-C
- Richmond Hill Adult Day Care Center Inc
- Richmond Hill Dental Group, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.