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MS. SARA DEBORAH BACK FNP MPH
NPI 1104811991
Nurse Practitioner - Family in Bronx, NY

Active since September 17, 2005PECOS Enrolled
3424 KOSSUTH AVE, RM #3H17, BRONX, NY 10467(718) 519-3631(718) 519-2034 Get Directions Write a Review

NPPES record last updated: July 9, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Sara Deborah Back Fnp Mph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SARA DEBORAH BACK FNP MPH (NPI 1104811991) is an individual family provider in Bronx, New York, licensed in New York (F333271) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104811991
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMS. SARA DEBORAH BACKCredential: FNP MPH
Location Address3424 KOSSUTH AVE, RM #3H17Bronx, NY 10467-2410
Mailing Address80 Lasalle St, 9cNew York, NY 10027-4713 · (212) 316-2445
Phone(718) 519-3631
Fax(718) 519-2034
Sole ProprietorNo
Enumeration DateSeptember 17, 2005
Last NPPES UpdateJuly 9, 2008
✔ NPI 1104811991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · F333271
3424 KOSSUTH AVE, Bronx, NY 10467
Open in Google Maps ↗

Other Identifiers 1

Medicaid02108950NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Sara Deborah Back Fnp Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10467 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
1 supplier11 claims30 services$4.26 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. PERVEZ ALI RPH
Pharmacist
3424 KOSSUTH AVE
BRONX, NY 10467
Bronx County (718) 519-3575
MRS. DORINA M. SANDU RPH., MS
Pharmacist
3424 KOSSUTH AVE
BRONX, NY 10467
Bronx County (718) 519-3579
ROCHIELLE CORLETTE MA, LCAT, ATR-BC
Art Therapist
3424 KOSSUTH AVE
BRONX, NY 10467
Bronx County (718) 519-5000
NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
General Acute Care Hospital
3424 KOSSUTH AVE
BRONX, NY 10467
Bronx County (718) 918-3677
MRS. MIRIAM STEPHANIE JUNOR CDE
Registered Nurse (Diabetes Educator)
3424 KOSSUTH AVE
BRONX, NY 10467
Bronx County (718) 515-1434
MR. THOMAS PAUL RUFF JR. PA-C
Physician Assistant (Medical)
3424 KOSSUTH AVE
BRONX, NY 10467
Bronx County (718) 519-5000
NATASHA TATUM LCSW
Social Worker (Clinical)
3424 KOSSUTH AVE
BRONX, NY 10467
Bronx County (718) 519-4777
DR. STRAHINJA GLIGOREVIC MD
Student in an Organized Health Care Education/Training Program
3424 KOSSUTH AVE
BRONX, NY 10467
Bronx County (718) 519-3817

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sara Back's NPI number?

The NPI number for Sara Back is 1104811991. It was assigned to this individual provider in the NPPES registry on September 17, 2005.

Where is Sara Back located?

Sara Back practices at 3424 Kossuth Ave Rm #3h17, Bronx, NY 10467. The listed phone number is (718) 519-3631.

What is Sara Back's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Sara Back enrolled in Medicare?

Yes. Sara Back is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Sara Back was last updated on July 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.