Mumtaz Jahan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

216654 Issued in NY

Practice address

2748 Butler St
East Elmhurst, NY 11369-1928

Phone

(718) 576-6667

NPI assigned

May 27, 2006

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

Medicare fee-for-service enrollment

Enrolled in IN, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjahan8736@prd.direct.tbh.org

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.

• Jahan Medical Service PC

  • Adult Medicine Physician
  • Brooklyn, NY
  • NPI 1962758557
  Medicare reassignment NPD Authorized official
• Indiana University Health Ball Memorial Physicians, Inc.

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1235455544
  Medicare reassignment NPD
• Caledonian Health Center

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1184657355
  NPD (past)
• Forest Hills Dermatology Group PLLC

  • Dermatology Physician
  • Kew Gardens, NY
  • NPI 1225309586
  NPD (past)
• RLD Medical Services, PC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1609986934
  NPD (past)
• Pine Ridge Indian Health Service Hospital

  dba Wanblee Health Center

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD (past)
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1952358079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-250-8000",
            "fax_number": "718-250-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2748 BUTLER ST",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113691928",
            "telephone_number": "718-576-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHAN",
        "first_name": "MUMTAZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "216654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freda Itua
• Jackson Children's Services
• Jackson Developmental Center
• Jackson Heights Medical Center
• Jackson Heights Vision Care Inc (Pearle Vision)
• Marjorie Rosalind James, M.S. CCC-SLP
• Gladys M Japa, LPN
• Hope G Jarrett-Davis, P.T.
• Rangika S Jayarathne
• Curtis M Johnson, DDS

• Family Medicine Physician in East Elmhurst, NY
• Providers in East Elmhurst, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.