Athar Mujtaba, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

344517 Issued in NY

Practice address

10426 Roosevelt Ave
Corona, NY 11368

Phone

(718) 533-0991

Fax

(833) 969-0190

NPI assigned

Jun 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

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

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.

• Mujtaba NP in Family Health, P.C.

  • Family Nurse Practitioner
  • Corona, NY
  • NPI 1639765704

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1891355400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10426 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-533-0991",
            "fax_number": "833-969-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10426 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-533-0991",
            "fax_number": "833-969-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUJTABA",
        "first_name": "ATHAR",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercedes Mota-Martinez, DDS
• Motion Forward Physical Therapy PC
• Stacy Moyston
• Mujtaba NP in Family Health, P.C.
• Mujtaba Women'S Health Midwifery PC
• Ayesha Mujtaba, ARNP, CNM
• Larisa Mullodzhanova, M.S., OTR/L
• Mazal Mullodzhanova
• Violetta Munarova, PHARMD
• Shikha Patel Muni, DO

• Family Nurse Practitioner in Corona, NY
• Providers in Corona, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.