Individual provider Active NPI

Shamim Ahmed, MD

  • Internal Medicine Physician
  • Woodside, NY
National Provider Identifier
1003839655
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
237709 Issued in NY
Practice address
6413 Broadway
Woodside, NY 11377-2336
Phone
(718) 205-6561
Fax
(718) 205-4815
NPI assigned
Jul 25, 2006
Last updated
May 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 237709 NY Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 237709 NY

Addresses

Primary practice location

6413 Broadway
Woodside, NY 11377-2336

Mailing address

10 Barrypark CT
Albertson, NY 11507-1502
Phone (718) 205-6561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050628000400 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 3870538028 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6413 Broadway
Woodside, NY 11377-2336
Phone (718) 205-6561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
001559NYMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
C&T Medical Center Inc Internal Medicine CurrentSince Dec 13, 2025 Accepting new patients
Interfaith Emergency Medicine, P.C. Current Accepting new patients
Interfaith Professional Physician Services, P.C. Internal Medicine CurrentSince Jan 1, 2012 Accepting new patients
Ny Medical Physicians PC Internal Medicine CurrentSince Jun 6, 2026 Accepting new patients
Interfaith Medical Center Internal Medicine Past Accepting new patients
Omni Medical Group PLLC Internal Medicine Past Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

7415 37th Ave
Jackson Hts, NY 11372
Phone (718) 276-4482

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJEHDD/Endpoint/BJEHDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/EADEBA/Endpoint/EADEBA

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1003839655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BARRYPARK CT",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071502",
            "telephone_number": "718-205-6561",
            "fax_number": "718-205-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6413 BROADWAY",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772336",
            "telephone_number": "718-205-6561",
            "fax_number": "718-205-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "SHAMIM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "237709",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "237709",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.