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STATION CARE NP IN ADULT HEALTH PC
NPI 1801605761
Nurse Practitioner - Adult Health in Brentwood, NY

Active since January 06, 2025CLIA 33D2338776 · Waiver
55 2ND AVE UNIT 2, BRENTWOOD, NY 11717(631) 983-3237(631) 961-8775 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 12, 2026, Nov 23, 2025, Jan 6, 2025 (3 updates tracked since 2025).

About Station Care Np In Adult Health Pc NPPES

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

STATION CARE NP IN ADULT HEALTH PC (NPI 1801605761) is a healthcare organization registered as an adult health in Brentwood, New York and active in the NPI registry since January 2025. The organization holds a CLIA Waiver certificate valid through February 17, 2028 and lists Mubushar Ikram Raza, Owner/ Agnp, as its authorized official.

NPPES Registry Identity

NPI1801605761
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameSTATION CARE NP IN ADULT HEALTH PC
Location Address55 2ND AVE UNIT 2Brentwood, NY 11717-4665
Mailing Address55 2nd Ave Unit 2Brentwood, NY 11717-4665 · (631) 983-3237 · Fax (631) 961-8775
Phone(631) 983-3237
Fax(631) 961-8775
Organization SubpartNo
Authorized OfficialMubushar Ikram RazaOwner/ Agnp · (631) 961-8775
Enumeration DateJanuary 6, 2025
Last NPPES UpdateJune 29, 20263 updates tracked since enumeration
NPPES CertifiedJune 29, 2026
✔ NPI 1801605761 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
55 2ND AVE UNIT 2, Brentwood, NY 11717
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Station Care Np In Adult Health 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 Station Care Np In Adult Health PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mubushar Raza
Nurse Practitioner
NPI 1588017164
55 2ND AVE UNIT 2
Brentwood, NY 11717
(631) 983-3237
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2338776

Station Care Np In Adult Health PC · Brentwood, NY
Active · expires Feb 17, 2028
CLIA Number33D2338776
Laboratory TypeMedical Office Np Owned
Certificate Effective DateFebruary 18, 2026
Certificate Expiration DateFebruary 17, 2028
Laboratory DirectorMubushar I. Raza
Laboratory Phone(631) 983-3237
Laboratory LocationStation Care Np In Adult Health PC55 Second Ave Unit 2, Brentwood, NY 11717
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Station Care Np In Adult Health PC's NPI number?

The NPI number for Station Care Np In Adult Health PC is 1801605761. It was assigned to this organization in the NPPES registry on January 6, 2025.

Where is Station Care Np In Adult Health PC located?

Station Care Np In Adult Health PC is located at 55 2nd Ave Unit 2, Brentwood, NY 11717. The listed phone number is (631) 983-3237.

What is Station Care Np In Adult Health PC's specialty?

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

Is Station Care Np In Adult Health PC enrolled in Medicare?

Yes. Station Care Np In Adult Health PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Station Care Np In Adult Health PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Station Care Np In Adult Health 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.

Does Station Care Np In Adult Health PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2338776) is associated with this NPI, valid through February 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Station Care Np In Adult Health PC was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.