Individual provider Active NPI

Syed Kazim, M.D

  • Geriatric Medicine (Internal Medicine) Physician
  • Bronx, NY
National Provider Identifier
1861442303
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
223476 Issued in NY
Practice address
130 W Kingsbridge Rd
Dept. of Veterans Affairs/James J Peters VA Med.Center
Bronx, NY 10468-3904
Phone
(718) 584-9000
NPI assigned
May 12, 2006
Last updated
Jun 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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 223476 NY
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 223476 NY Primary

Addresses

Primary practice location

130 W Kingsbridge Rd
Dept. of Veterans Affairs/James J Peters VA Med.Center
Bronx, NY 10468-3904

Mailing address

141-25 71 Ave
Flushing, NY 11367-1940
Phone (347) 351-9470

Other identifiers 1

IdentifierTypeStateIssuer
223476OtherNYNY STATE LICENSE #

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
I20130507000252 NY Order and Referring Only - Internal MedicinePractitioner - Internal MedicinePractitioner - Geriatric Medicine 5496992661

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1861442303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141-25 71 AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671940",
            "telephone_number": "347-351-9470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W KINGSBRIDGE RD",
            "address_2": "DEPT. OF VETERANS AFFAIRS/JAMES J PETERS VA MED.CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683904",
            "telephone_number": "718-584-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZIM",
        "first_name": "SYED",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "223476",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "223476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE #",
            "identifier": "223476",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.