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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: October 18, 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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Mubushar Raza reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Station Care Np In Adult Health PC
Same address
Adult Health
55 2ND AVE UNIT 2
Brentwood, NY 11717
  • Reassigned Medicare billing, New York enrollment
NPI 1801605761 (631) 983-3237

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 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 4

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

USEMMA KHAN RN
Registered Nurse
55 2ND AVE UNIT 2
BRENTWOOD, NY 11717
Suffolk County (917) 670-0948
AQSA CHAUDHRI NP
Nurse Practitioner (Adult Health)
55 2ND AVE UNIT 2
BRENTWOOD, NY 11717
Suffolk County (631) 983-3237
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.

Which organization bills Medicare for Mubushar Raza's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mubushar Raza reassigns Medicare benefits to Station Care Np In Adult Health PC (Brentwood, NY). The 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 Mubushar Raza's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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 8 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.