Farzana Matin, M.D., P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

258280 Issued in NY

Legal business name

FARZANA MATIN, M.D., P.C.

Practice address

4024 76TH St Ste 1Ab
Elmhurst, NY 11373-1009

Phone

(718) 844-6302

NPI assigned

Dec 1, 2017

Organization subpart

No

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

Authorized official

Name

Farzana Matin, MDNPI 1295979698

Title

Director/Ceo

Phone

(917) 405-1517

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Farzana Matin

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1295979698
  Medicare reassignment NPD Authorized official
• Shayma R Mazumder, MD

  • Internal Medicine Physician
  • Garden City, NY
  • NPI 1609658780
  NPD

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696032000000",
    "number": "1699280453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HILTON AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304400",
            "telephone_number": "917-405-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 76TH ST STE 1AB",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731009",
            "telephone_number": "718-844-6302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26019 Nassau Blvd",
            "address_purpose": "LOCATION",
            "city": "Little Neck",
            "state": "NY",
            "postal_code": "113622241",
            "country_code": "US",
            "telephone_number": "917-405-1517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Saint Pauls Pl",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110212636",
            "country_code": "US",
            "telephone_number": "917-405-1517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FARZANA MATIN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-01",
        "last_updated": "2023-09-30",
        "certification_date": "2023-09-30",
        "status": "A",
        "authorized_official_last_name": "MATIN",
        "authorized_official_first_name": "FARZANA",
        "authorized_official_title_or_position": "DIRECTOR/CEO",
        "authorized_official_telephone_number": "917-405-1517",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "258280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03387726",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.