Sourab Choudhury, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

226018 Issued in NY

Practice address

161 Atlantic Ave
Suite 202
Brooklyn, NY 11201-6720

Phone

(718) 797-5504

NPI assigned

Mar 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

Michigan State University College of Osteopathic Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAA

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.

• Bobby Buka, M.D., P.C.

  • Dermatology Physician
  • New York, NY
  • NPI 1134349954
  Medicare reassignment Care Compare group NPD
• Children'S Skin and Laser, PC

  • Pediatric Dermatology Physician
  • Brooklyn, NY
  • NPI 1265618532
  Medicare reassignment NPD Authorized official
• Forest Hills Dermatology Group PLLC

  • Dermatology Physician
  • Kew Gardens, NY
  • NPI 1225309586
  NPD (past)
• Mount Sinai Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1932103413
  NPD (past)
• Out East Medical

  • Dermatology Physician
  • Oceanside, NY
  • NPI 1730757311
  NPD (past)
• Specialist Peds at Lich

  • Pediatric Endocrinology Physician
  • Brooklyn, NY
  • NPI 1922055045

  Dermatology

  NPD (past)
• Suny Downstate Medical Center

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1699704155
  NPD (past)
• Suny Health Science Center at Brooklyn

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1386942555
  NPD (past)
• Ted Brezel MD

  • Procedural Dermatology Physician
  • Glendale, NY
  • NPI 1093910192
  NPD (past)
• Atlas Infectious Disease Practice PLLC

  • Infectious Disease Physician
  • Atlantis, FL
  • NPI 1326655846
  NPD (past)
• Derm Specs of PA PLLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1528823507
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1861453698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 ATLANTIC AVE",
            "address_2": "SUITE 202",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016720",
            "telephone_number": "718-797-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 ATLANTIC AVE",
            "address_2": "SUITE 202",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016720",
            "telephone_number": "718-797-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDHURY",
        "first_name": "SOURAB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "226018",
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NY",
            "license": "226018",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02358652",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Violette Choudhry, RN
• Zoia Choudhry
• Alexandria Choudhury
• Mushfique Choudhury, M.D
• Nishat Choudhury
• Sydul Hasan Choudhury, MD
• Zerin Choudhury, PA-C
• Haris Mansur Choudry, M.D.
• Muhammad Obaid Ullah Choudry
• Jack Choueka, MD

• Dermatology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.