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

Q: 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.

Q: What is Sara Back's specialty?

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

Q: 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.

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: October 25, 2026.

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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

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Other Identifiers 1

Medicaid02108950NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Sara Back reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Institute For Family Health

2.6 mi

Family Medicine

1894 WALTON AVE
Bronx, NY 10453

Reassigned Medicare billing, New York enrollment
347 clinicians in this Medicare group

NPI 1053685289 (718) 583-3060

Mission Medical Care PC

20 mi

Internal Medicine

265 SUNRISE HWY STE 1-274
Rockville Centre, NY 11570

Reassigned Medicare billing, New York enrollment
49 clinicians in this Medicare group

NPI 1750898565 (212) 803-3339

Ny Medical Providers, PLLC

26 mi

Internal Medicine

4 LEGENDS CIRCLE
Melville, NY 11747

Reassigned Medicare billing, New York enrollment
10 clinicians in this Medicare group

NPI 1649123704 (516) 499-3165

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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