Individual provider Active NPI

Mahmoud Mohammedamin M Bokhari, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Bay Shore, NY
National Provider Identifier
1922654037
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
305120 Issued in NY
Practice address
39 Brentwood Rd
Bay Shore, NY 11706-8031
Phone
(631) 968-3000
NPI assigned
Aug 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 305120 NY Primary

Addresses

Primary practice location

39 Brentwood Rd
Bay Shore, NY 11706-8031

Mailing address

39 Brentwood Rd
Bay Shore, NY 11706-8031
Phone (631) 968-3000

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
I20200925001925 NY Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 8224457122 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Oct 5, 2020 Accepting new patients
Advantagecare Physicians PC CurrentSince Oct 5, 2020 Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

300 Bay Shore Rd
North Babylon, NY 11703
Phone (631) 586-2700

640 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 737-0100

Interoperability endpoints

  • Direct secure messaging: mahmoudbokhari@nslijmedgr.allscriptsdirect.net
  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1922654037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 BRENTWOOD RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068031",
            "telephone_number": "631-968-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 BRENTWOOD RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068031",
            "telephone_number": "631-968-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOKHARI",
        "first_name": "MAHMOUD",
        "middle_name": "MOHAMMEDAMIN M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-14",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NY",
            "license": "305120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.