NPIMap

Individual provider Active NPI

Imad Mikhail, MD

  • Internal Medicine Physician
  • Roslyn, NY
National Provider Identifier
1962573220
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2410251 Issued in NY
Practice address
63 Mineola Ave
Roslyn, NY 11576-2001
Phone
(646) 325-3463
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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 2410251 NY Primary

Addresses

Primary practice location

63 Mineola Ave
Roslyn, NY 11576-2001

Mailing address

63 Mineola Ave
Roslyn, NY 11576-2001
Phone (646) 325-3463

Other identifiers 2

IdentifierTypeStateIssuer
271SM1OtherNYNY EMPIRE BCBS
02825056MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070906000679 NY Practitioner - Internal Medicine 3870686835 Reassigns benefits to 2 organizations
Practice locations: Manhasset, NY; Mineola, NY; New Hyde Park, NY; Rockville Centre, NY; Roslyn, NY; West Hempstead, NY; East Meadow, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

510 Hempstead Tpke
RM 207
West Hempstead, NY 11552-1152
Phone (516) 486-1953

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.2 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2410251NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2013 Accepting new patients
Imad Mikhail Medical PLLC Internal Medicine CurrentSince Sep 27, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
R.G. Medical, PC Past Accepting new patients
NYU Langone Hospitals Past Accepting new patients
Cogent Medical Care PC Internal Medicine Past Accepting new patients
Mercy Medical Center Past Accepting new patients
Long Island Emergency Care PC Past Accepting new patients

Locations

2715 30th Ave
Long Island City, NY 11102
Phone (718) 267-4808

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

510 Hempstead Tpke
Rm 207
West Hempstead, NY 11552
Phone (516) 486-1953

Networks

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

Interoperability endpoints

  • Direct secure messaging: imikhail307597@nyumc.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1962573220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MINEOLA AVE",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762001",
            "telephone_number": "646-325-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MINEOLA AVE",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762001",
            "telephone_number": "646-325-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAIL",
        "first_name": "IMAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "2410251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY EMPIRE BCBS",
            "identifier": "271SM1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02825056",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.