Shamim Ahmed, MD
Individual provider Active NPI Internal Medicine Physician · Woodside, NY
NPI 1003839655 · NPPES record last updated May 28, 2015
Key facts
- NPI
- 1003839655
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 237709 (NY)
- Practice address
- 6413 Broadway
Woodside, NY 11377-2336 - Phone
- (718) 205-6561
- Fax
- (718) 205-4815
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Internal 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050628000400 | NY | Practitioner - Internal Medicine |
3870538028 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001559 | NY | MD | Art Therapist |
Practice roles (6 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C&T Medical Center Inc | Internal Medicine | Current |
Accepting new patients |
| Ny Medical Physicians PC | Internal Medicine | Current |
Accepting new patients |
| Interfaith Emergency Medicine, P.C. | Current | Accepting new patients | |
| Interfaith Professional Physician Services, P.C. | Internal Medicine | Current |
Accepting new patients |
| Omni Medical Group PLLC | Internal Medicine | Past | Accepting new patients |
| Interfaith Medical Center | 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
- https://fhir4.healow.com/fhir/r4/BJEHDD/Endpoint/BJEHDD
- https://fhir4.healow.com/fhir/r4/EADEBA/Endpoint/EADEBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 237709 | NY | Yes |
| 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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02322732 | Medicaid | NY |
Other providers in Woodside, NY
- Aftab Ahmed
- Hadil Ahmed
- Nahida Ahmed
- Niaz Ahmed
- Rakshenda Ahmed
- Dina M Ajmera
- Hemali M Ajmera
- Aka Medical Wellness and Aesthetics LLC
- Ayesha Akhter
- Layla K Alaouie
All providers in Woodside, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.