Individual provider Active NPI

Tahmina Chowdhury, MD, F.A.A.P

  • Pediatrics Physician
  • Smithtown, NY
National Provider Identifier
1982268165
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
317485 Issued in NY
Practice address
50 Route 111 Ste 208
Smithtown, NY 11787-3700
Phone
(631) 361-2121
NPI assigned
Apr 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 317485 NY Primary

Addresses

Primary practice location

50 Route 111 Ste 208
Smithtown, NY 11787-3700

Mailing address

50 Route 111 Ste 208
Smithtown, NY 11787-3700
Phone (631) 361-2121

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
I20240823000855 NY Practitioner - Pediatric Medicine 2769865344 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
317485NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince May 7, 2024 Accepting new patients
Optum Medical Care, P.C. CurrentSince May 7, 2024 Accepting new patients
Mount Kisco Medical Group PastSince Sep 5, 2023 Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Networks

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

Interoperability endpoints

  • Direct secure messaging: tchowdhury93503@direct.optum.com
  • Direct secure messaging: tchowdhury2148296@nychhc.direct-ci.com

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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1982268165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ROUTE 111 STE 208",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873700",
            "telephone_number": "631-361-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ROUTE 111 STE 208",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873700",
            "telephone_number": "631-361-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOWDHURY",
        "first_name": "TAHMINA",
        "credential": "MD, F.A.A.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "317485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.