Individual provider Active NPI

Mervat A Mourad, D.O.

  • Internal Medicine Physician
  • Greenvale, NY
National Provider Identifier
1740435098
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
257694 Issued in NY
Practice address
600 Northern Blvd
Greenvale, NY 11548-1214
Phone
(516) 686-3849
Fax
(516) 686-3834
NPI assigned
Nov 27, 2008
Last updated
May 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 257694 NY Primary

Addresses

Primary practice location

600 Northern Blvd
Greenvale, NY 11548-1214

Mailing address

600 Northern Blvd
Greenvale, NY 11548-1214
Phone (516) 686-3849

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
I20101117001014 NY Practitioner - Internal Medicine 7618162587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Institute of TechnologyGroup PAC ID 3779496039, 42 clinicians

Practice addresses (Care Compare)

267 Carleton Ave
Central Islip, NY 11722-4543
Phone (631) 348-3254

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York Institute of Technology CurrentSince May 4, 2015 Accepting new patients
New York Institute of Technology Internal Medicine Current Accepting new patients
New York Institute of Technology CurrentSince May 4, 2015 Accepting new patients

Locations

267 Carleton Ave
Central Islip, NY 11722
Phone (631) 348-3254

600 Northern Blvd
Greenvale, NY 11548
Phone (516) 686-3849

Networks

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

Interoperability endpoints

  • Direct secure messaging: mervat.mourad@nyitahcc.eclinicaldirectplus.com

Organizations & group practices 3

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": "1227744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1740435098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NORTHERN BLVD",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481214",
            "telephone_number": "516-686-3849",
            "fax_number": "516-686-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NORTHERN BLVD",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481214",
            "telephone_number": "516-686-3849",
            "fax_number": "516-686-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURAD",
        "first_name": "MERVAT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-27",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "257694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenvale, NY

Sources for this page

Verify at the official NPI Registry.