NPIMap

Individual provider Active NPI

Adeel Azmat Iqbal, D.O.

  • Internal Medicine Physician
  • Patchogue, NY
National Provider Identifier
1780996983
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
260863 Issued in NY
Practice address
152 North Ocean Ave.
Patchogue, NY 11772
Phone
(631) 913-8239
Fax
(631) 207-8303
NPI assigned
Jul 6, 2010
Last updated
Apr 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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 260863 NY Primary

Addresses

Primary practice location

152 North Ocean Ave.
Patchogue, NY 11772

Mailing address

152 North Ocean Ave.
Patchogue, NY 11772
Phone (631) 913-8239

Other identifiers 1

IdentifierTypeStateIssuer
A3377144MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110914000769 NY Practitioner - Internal Medicine 7810174539 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
Telehealth
Offers telehealth services
Group practices
North Ocean Medical Group P.C.Group PAC ID 0143460634, 3 clinicians

Practice addresses (Care Compare)

152 N Ocean Ave
Patchogue, NY 11772-2004
Phone (631) 913-8239

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
260863NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Ocean Home Care Inc Internal Medicine Current Accepting new patients
Berkshire Nursing Home, LLC Past Accepting new patients
Long Island Integrative Functional Medicine, PC Past Accepting new patients
North Sea Associates LLC Past Accepting new patients
Nursing Care Center at Medford Inc Past Accepting new patients
L&a Operational LLC Past Accepting new patients

Networks

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

Organizations & group practices 7

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1780996983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 NORTH OCEAN AVE.",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-913-8239",
            "fax_number": "631-207-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 NORTH OCEAN AVE.",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-913-8239",
            "fax_number": "631-207-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "ADEEL",
        "middle_name": "AZMAT",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "260863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A3377144",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.