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ABDUL-SAMAD MIRZA
NPI 1619430782
Neuromusculoskeletal Medicine & OMM in Garden City, NY

Active since April 07, 2019PECOS EnrolledAccepts Medicare Assignment
107 MITCHEL FIELD WAY, GARDEN CITY, NY 11530(631) 813-6869 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 20, 2023, Apr 7, 2019 (2 updates tracked since 2019).

About Abdul-samad Mirza NPPES

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

ABDUL-SAMAD MIRZA (NPI 1619430782) is an individual neuromusculoskeletal medicine & omm provider in Garden City, New York, licensed in New York (323388) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2022).

NPPES Registry Identity

NPI1619430782
Entity TypeIndividualMale
Primary Taxonomy204D00000X
Provider Legal NameABDUL-SAMAD MIRZA
Location Address107 MITCHEL FIELD WAYGarden City, NY 11530-5034
Mailing Address107 Mitchel Field WayGarden City, NY 11530-5034 · (631) 813-6869
Phone(631) 813-6869
Sole ProprietorYes
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2022
Enumeration DateApril 7, 2019
Last NPPES UpdateApril 17, 20252 updates tracked since enumeration
NPPES CertifiedApril 17, 2025
✔ NPI 1619430782 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeuromusculoskeletal Medicine & OMMAllopathic & Osteopathic Physicians
Taxonomy Code204D00000X
Licenses✔ Licensed in NY · 323388✔ Licensed in FL · OS18253
Definition
The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients.
107 MITCHEL FIELD WAY, Garden City, NY 11530
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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

Abdul-samad Mirza 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 ID4587992946
PECOS Enrollment IDI20250513001485
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

2

Medicare enrollment records show Abdul-samad Mirza reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pain Physicians Ny PLLC
20 mi
Interventional Pain Medicine
240 EAST 23RD STREET
New York, NY 10010
  • Reassigned Medicare billing, New York enrollment
  • 7 clinicians in this Medicare group
NPI 1538465497 (212) 757-0222
Lr Medical PLLC
21 mi
Interventional Pain Medicine
2277-83 CONEY ISLAND AVE, SUITE 2A
Brooklyn, NY 11223
  • Reassigned Medicare billing, New York enrollment
  • 12 clinicians in this Medicare group
NPI 1760808802 (718) 998-9890

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 Abdul-samad Mirza's NPI number?

The NPI number for Abdul-samad Mirza is 1619430782. It was assigned to this individual provider in the NPPES registry on April 7, 2019.

Where is Abdul-samad Mirza located?

Abdul-samad Mirza practices at 107 Mitchel Field Way, Garden City, NY 11530. The listed phone number is (631) 813-6869.

What is Abdul-samad Mirza's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine & OMM with taxonomy code 204D00000X.

Is Abdul-samad Mirza enrolled in Medicare?

Yes. Abdul-samad Mirza 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 organizations bill Medicare for Abdul-samad Mirza's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Abdul-samad Mirza reassigns Medicare benefits to 2 organizations: Pain Physicians Ny PLLC (New York, NY) and Lr Medical PLLC (Brooklyn, NY). Each 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 Abdul-samad Mirza'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 Abdul-samad Mirza was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.