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MUBUSHAR IKRAM RAZA
NPI 1588017164
Nurse Practitioner - Adult Health in Brentwood, NY

Active since July 19, 2016PECOS EnrolledAccepts Medicare Assignment
55 2ND AVE UNIT 2, BRENTWOOD, NY 11717(631) 983-3237(631) 961-8775 Get Directions Write a Review

NPPES record last updated: January 23, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 23, 2026, Jun 27, 2025, Aug 2, 2024 and 1 more (4 updates tracked since 2024).

About Mubushar Ikram Raza NPPES

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

MUBUSHAR IKRAM RAZA (NPI 1588017164) is an individual adult health provider in Brentwood, New York, licensed in New York (307814) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS and is a graduate of State University Of New York At Stony Brook, School Of Medicine (2016).

NPPES Registry Identity

NPI1588017164
Entity TypeIndividualMale
Primary Taxonomy363LA2200X
Provider Legal NameMUBUSHAR IKRAM RAZA
Location Address55 2ND AVE UNIT 2Brentwood, NY 11717-4665
Mailing Address55 2nd Ave Unit 2Brentwood, NY 11717-4665 · (631) 983-3273 · Fax (631) 961-8775
Phone(631) 983-3237
Fax(631) 961-8775
Sole ProprietorYes
Medical School CMSState University Of New York At Stony Brook, School Of MedicineGraduated 2016
Enumeration DateJuly 19, 2016
Last NPPES UpdateJanuary 23, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 23, 2026
✔ NPI 1588017164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in NY · 307814
55 2ND AVE UNIT 2, Brentwood, NY 11717
Open in Google Maps ↗

Other Identifiers 1

Other307814NY · 307814

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mubushar Ikram Raza is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648548586
PECOS Enrollment IDI20170616001319
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 11717 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.

Other Providers at the Same Location NPPES 2

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

STATION CARE NP IN ADULT HEALTH PC
Nurse Practitioner (Adult Health)
55 2ND AVE UNIT 2
BRENTWOOD, NY 11717
Suffolk County (631) 983-3237
MRS. ANISHA SARA CHACKO NP
Nurse Practitioner (Family)
55 2ND AVE UNIT 2
BRENTWOOD, NY 11717
Suffolk County (631) 983-3237

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 Mubushar Raza's NPI number?

The NPI number for Mubushar Raza is 1588017164. It was assigned to this individual provider in the NPPES registry on July 19, 2016.

Where is Mubushar Raza located?

Mubushar Raza practices at 55 2nd Ave Unit 2, Brentwood, NY 11717. The listed phone number is (631) 983-3237.

What is Mubushar Raza's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Mubushar Raza enrolled in Medicare?

Yes. Mubushar Raza is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Mubushar Raza was last updated on January 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.