Individual provider Active NPI

Urooj Shabbir, PA-C

  • Physician Assistant
  • Plainview, NY
National Provider Identifier
1033096771
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
255 Executive Dr Ste 210B
Plainview, NY 11803-1711
Phone
(516) 687-9563
NPI assigned
Aug 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY Primary

Addresses

Primary practice location

255 Executive Dr Ste 210B
Plainview, NY 11803-1711

Mailing address

255 Executive Dr Ste 210B
Plainview, NY 11803-1711
Phone (516) 687-9563

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251211001932 NY Practitioner - Physician Assistant 8527552009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

255 Executive Dr
Plainview, NY 11803-1718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
034555NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Medical of New York PLLC CurrentSince Oct 28, 2025 Accepting new patients

Locations

255 Executive Dr
Ste 210B
Plainview, NY 11803
Phone (516) 687-9563

10 Maple St
Prt Washingtn, NY 11050
Phone (917) 746-5942

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1033096771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 EXECUTIVE DR STE 210B",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031711",
            "telephone_number": "516-687-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EXECUTIVE DR STE 210B",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031711",
            "telephone_number": "516-687-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABBIR",
        "first_name": "UROOJ",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.