Individual provider Active NPI

Andrin Kasemi, MD

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1871814277
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
271330 Issued in NY
Practice address
2315 Victory Blvd.
Victory Internal Medicine
Staten Island, NY 10314
Phone
(718) 477-6900
Fax
(718) 477-7862
NPI assigned
Jun 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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 271330 NY Primary

Addresses

Primary practice location

2315 Victory Blvd.
Victory Internal Medicine
Staten Island, NY 10314

Mailing address

2315 Victory Blvd.
Victory Internal Medicine
Staten Island, NY 10314
Phone (718) 477-6900

Other identifiers 2

IdentifierTypeStateIssuer
03823567MedicaidNY
A400095002OtherNYMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
271330NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1276992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1871814277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 VICTORY BLVD.",
            "address_2": "VICTORY INTERNAL MEDICINE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-477-6900",
            "fax_number": "718-477-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 VICTORY BLVD.",
            "address_2": "VICTORY INTERNAL MEDICINE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-477-6900",
            "fax_number": "718-477-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASEMI",
        "first_name": "ANDRIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-20",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "271330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03823567",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A400095002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.