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JUSTIN MIRZA D.O. PC
NPI 1508252321
Orthopaedic Surgery - Hand Surgery in Smithtown, NY

Active since April 08, 2015
290 E MAIN ST, SUITE 200, SMITHTOWN, NY 11787(631) 361-5302(631) 361-8607 Get Directions Write a Review

NPPES record last updated: April 8, 2015. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Justin Mirza D.o. Pc NPPES

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

JUSTIN MIRZA D.O. PC (NPI 1508252321) is a healthcare organization registered as a hand surgery in Smithtown, New York and active in the NPI registry since April 2015. The organization lists Justin Bruno Mirza, President, as its authorized official.

NPPES Registry Identity

NPI1508252321
Entity TypeOrganization
Primary Taxonomy207XS0106X
Legal Business NameJUSTIN MIRZA D.O. PC
Location Address290 E MAIN ST, SUITE 200Smithtown, NY 11787-2916
Mailing Address290 E Main St, Suite 200Smithtown, NY 11787-2916 · (631) 361-5302 · Fax (631) 361-8607
Phone(631) 361-5302
Fax(631) 361-8607
Organization SubpartNo
Authorized OfficialJustin Bruno MirzaPresident · (631) 361-5302
Enumeration DateApril 8, 2015
✔ NPI 1508252321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Hand SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207XS0106X
License✔ Licensed in NY · 258198
Definition
An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
290 E MAIN ST, Smithtown, NY 11787
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Mirza D.o. Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Justin Mirza D.O. PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Justin Mirza, DO
Orthopedic Surgery
NPI 1356648570
51-15 BEACH CHANNEL DRIVE PENINSULA HOSPITAL CENTER
Far Rockaway, NY 11691
(718) 734-3020
✔ PECOS✔ Accepts Medicare37 mi

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

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 Justin Mirza D.O. PC's NPI number?

The NPI number for Justin Mirza D.O. PC is 1508252321. It was assigned to this organization in the NPPES registry on April 8, 2015.

Where is Justin Mirza D.O. PC located?

Justin Mirza D.O. PC is located at 290 E Main St Suite 200, Smithtown, NY 11787. The listed phone number is (631) 361-5302.

What is Justin Mirza D.O. PC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.

Is Justin Mirza D.O. PC enrolled in Medicare?

Yes. Justin Mirza D.O. PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Justin Mirza D.O. PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Orthopedic Surgery) reassigns their Medicare billing to Justin Mirza D.O. PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Justin Mirza D.O. PC was last updated on April 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.