Maryam Abubakar, AGNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F307879-1 Issued in NY

Practice address

366 Broadway
Amityville, NY 11701-1170

Phone

(631) 789-7421

NPI assigned

Aug 20, 2016

Last updated

Apr 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 9

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

State University of New York at Stony Brook, School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Shore Magnetic Resonance Imaging Associates PCGroup PAC ID 8729991971, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1427/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Shore Magnetic Resonance Imaging Associates PC

  dba Brunswick Medical Services PC

  • Specialist
  • Amityville, NY
  • NPI 1194736199
  Medicare reassignment Care Compare group NPD
• Edward Condon Medical PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Commack, NY
  • NPI 1811174519
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1942755830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 LOUDEN AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012736",
            "telephone_number": "631-789-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117011170",
            "telephone_number": "631-789-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUBAKAR",
        "first_name": "MARYAM",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-20",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307879-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Amityville",
            "affiliation": "N",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Amityville",
            "address_1": "366 Broadway",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117011170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Amityville",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Amityville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Amityville",
            "address_1": "366 Broadway",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117011170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Amityville",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Amityville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Amityville",
            "address_1": "366 Broadway",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117011170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Amityville",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Amityville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Amityville",
            "address_1": "366 Broadway",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117011170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Amityville",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Amityville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Amityville",
            "address_1": "366 Broadway",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117011170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Amityville",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Amityville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Amityville",
            "address_1": "366 Broadway",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117011170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Amityville",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Amityville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Amityville",
            "address_1": "366 Broadway",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117011170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Amityville",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Amityville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Amityville",
            "address_1": "366 Broadway",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117011170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Amityville",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Amityville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Amityville",
            "address_1": "366 Broadway",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117011170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Amityville, NY
• Providers in Amityville, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.