Individual provider Active NPI

Pegah Yousefzadeh, DO

  • Endocrinology, Diabetes & Metabolism Physician
  • New Hyde Park, NY
National Provider Identifier
1750674230
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
260358 Issued in NY
Practice address
2 Pro Health PLZ
Suite 201
New Hyde Park, NY 11042-1111
Phone
(516) 390-5760
Fax
(516) 390-5765
NPI assigned
May 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 260358 NY
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 260358 NY Primary

Addresses

Primary practice location

2 Pro Health PLZ
Suite 201
New Hyde Park, NY 11042-1111

Mailing address

2800 Marcus Ave
New Hyde Park, NY 11042-1113
Phone (516) 622-6000

Other names 1

  • Pegah Rabizadeh Former name

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
I20110726000240 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 1052589694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

16450 Crossbay Blvd
FL 2
Howard Beach, NY 11414-3749
Phone (718) 622-7405

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
260358NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC CurrentSince Jul 5, 2011 Accepting new patients
Optum Medical Care, P.C. CurrentSince Aug 12, 2023 Accepting new patients
Optum Medical Care, P.C. Endocrinology, Diabetes & Metabolism CurrentSince Aug 12, 2023 Accepting new patients
Physicians of University Hospital, PC Internal Medicine CurrentSince Jul 5, 2011 Accepting new patients
Mount Kisco Medical Group Endocrinology, Diabetes & Metabolism Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: pyousefzadeh18770@direct.optum.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1750674230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MARCUS AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421113",
            "telephone_number": "516-622-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PRO HEALTH PLZ",
            "address_2": "SUITE 201",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421111",
            "telephone_number": "516-390-5760",
            "fax_number": "516-390-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSEFZADEH",
        "first_name": "PEGAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-17",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "260358",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "260358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEGAH",
            "last_name": "RABIZADEH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.