Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mubushar Ikram Raza

Individual provider Adult Health Nurse Practitioner · NPI 1588017164

Mubushar Ikram Raza is a Nurse Practitioner in Brentwood, New York. Graduated from State University of New York at Stony Brook, School of Medicine in 2016, 10 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
10
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
NY
In the registry since
2016

Practice location Address checks out

55 2nd Ave Unit 2
Brentwood, NY 11717-4665
Phone: (631) 983-3237
Fax: (631) 961-8775
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 307814 (NY)

Record details

NPI number1588017164
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 19, 2016
Last updated in NPPESJanuary 23, 2026
Certification dateJanuary 23, 2026
Mailing address55 2nd Ave Unit 2, Brentwood, NY 11717-4665

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Brentwood