NPIMap

Individual provider Active NPI

Agha M Raza, MD

  • Neurology Physician
  • Islip, NY
National Provider Identifier
1790851939
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD434315 Issued in PA
Practice address
712 Main St
Islip, NY 11751-3620
Phone
(631) 666-3939
Fax
(631) 666-1860
NPI assigned
Nov 28, 2006
Last updated
Jul 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD434315 PA Primary

Addresses

Primary practice location

712 Main St
Islip, NY 11751-3620

Mailing address

712 Main St
Islip, NY 11751-3620
Phone (631) 666-3939

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
I20071126000525 NY Practitioner - Neurology 2062408230 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

77 Medford Ave
Patchogue, NY 11772-1281
Phone (631) 758-1910

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7063SDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
New York University CurrentSince Dec 7, 2022 Accepting new patients
New York University CurrentSince Dec 7, 2022 Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. Current Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. CurrentSince Oct 1, 2014 Accepting new patients
Long Island Community Hospital at NYU Langone Health CurrentSince Oct 1, 2014 Accepting new patients
Mainehealth Past Accepting new patients
Delta Physician Practices Past Accepting new patients
Delta Medical Group Neurology Past Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

77 Route 112
Patchogue, NY 11772
Phone (631) 207-2370

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

10 E Merrick Rd
Valley Stream, NY 11580
Phone (516) 256-2017

10 E Merrick Rd
Ste 205
Valley Stream, NY 11580
Phone (516) 216-5884

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Organizations & group practices 9

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1790851939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 MAIN ST",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513620",
            "telephone_number": "631-666-3939",
            "fax_number": "631-666-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 MAIN ST",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513620",
            "telephone_number": "631-666-3939",
            "fax_number": "631-666-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZA",
        "first_name": "AGHA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD434315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip, NY

Sources for this page

Verify at the official NPI Registry.