Individual provider Active NPI

John S Muthu, MBBS; MD

  • Student in an Organized Health Care Education/Training Program
  • Brooklyn, NY
National Provider Identifier
1962649426
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
528 Prospect Place
Brooklyn, NY 11238
Phone
(718) 613-6900
NPI assigned
Jan 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 003934 NY
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

528 Prospect Place
Brooklyn, NY 11238

Mailing address

1408 Wilson Rd
East Meadow, NY 11554-4436
Phone (516) 750-5432

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
I20150211000166 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7315262516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
271455NYMDLicensed Vocational Nurse
003934NYMDPhysical Therapy Assistant

Networks

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

Interoperability endpoints

  • Direct secure messaging: jmuthu1054780@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1962649426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 WILSON RD",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544436",
            "telephone_number": "516-750-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 PROSPECT PLACE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11238",
            "telephone_number": "718-613-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHU",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "MBBS; MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-20",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "003934",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.