Organization Active NPI

Bismillah 1 Corporation

Doing business as Elton Pharmacy

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1831529122
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
032397 Issued in NY
Legal business name
BISMILLAH 1 CORPORATION
Doing business as
Elton Pharmacy
Practice address
2992 Fulton St
Brooklyn, NY 11208-1124
Phone
(718) 827-8943
Fax
(718) 827-8195
NPI assigned
Nov 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Mahmood Naqvi
Title
Owner
Phone
(718) 827-8943

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 032397 NY Primary

Addresses

Primary practice location

2992 Fulton St
Brooklyn, NY 11208-1124

Mailing address

2992 Fulton St
Brooklyn, NY 11208-1124
Phone (718) 827-8943

Other identifiers 2

IdentifierTypeStateIssuer
2143253OtherPK
03794598MedicaidNY

Other names 1

  • Elton Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20140228001100 NY DME Supplier - Pharmacy 0941430417 Practice locations: Brooklyn, NY
O20210326002023 NY Part B Supplier - Mass Immunization (Roster Biller Only) 0941430417 Practice locations: Brooklyn, NY
O20230526000806 NY Part B Supplier - Pharmacy 0941430417 Practice locations: Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Bismillah 1 Corporation2992 Fulton St, Brooklyn, NY 11208-1124(718) 827-8943 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Jan 2, 2014

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1831529122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2992 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112081124",
            "telephone_number": "718-827-8943",
            "fax_number": "718-827-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2992 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112081124",
            "telephone_number": "718-827-8943",
            "fax_number": "718-827-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISMILLAH 1 CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "NAQVI",
        "authorized_official_first_name": "MAHMOOD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-827-8943"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143253",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03794598",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elton Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.