Individual provider Active NPI

Moosa Nejat, M.D.

  • Specialist
  • Great Neck, NY
National Provider Identifier
1972519965
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
108760 Issued in NY
Practice address
833 Northern Blvd
Suite 120
Great Neck, NY 11021-5315
Phone
(516) 829-0066
Fax
(516) 829-4544
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 108760 NY Primary

Addresses

Primary practice location

833 Northern Blvd
Suite 120
Great Neck, NY 11021-5315

Mailing address

25 Harbour Rd
Kings Point, NY 11024-1203
Phone (516) 829-6168

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
I20050322000174 NY Practitioner - Internal Medicine 7416902531 Practice locations: Great Neck, NY; Brooklyn, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
108760NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Barkan Medical Services, PC Past Accepting new patients
Luzato Medical Group P.C. Past Accepting new patients
Luzato Medical Group, P.C. Past Accepting new patients

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972519965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HARBOUR RD",
            "city": "KINGS POINT",
            "state": "NY",
            "postal_code": "110241203",
            "telephone_number": "516-829-6168",
            "fax_number": "516-829-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 NORTHERN BLVD",
            "address_2": "SUITE 120",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215315",
            "telephone_number": "516-829-0066",
            "fax_number": "516-829-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEJAT",
        "first_name": "MOOSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "108760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.