Individual provider Active NPI

Menachem Shalimhaiem

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1073065397
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020367 Issued in NY
Practice address
4426 18TH Ave
Brooklyn, NY 11204-1201
Phone
(718) 854-0001
Fax
(888) 530-3797
NPI assigned
Nov 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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 020367 NY Primary

Addresses

Primary practice location

4426 18TH Ave
Brooklyn, NY 11204-1201

Mailing address

938 E 26TH St
Brooklyn, NY 11210-3726
Phone (718) 377-0704

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
I20170123000196 NY Practitioner - Physician Assistant 3779865084 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York Downstate Medical Center, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perfect Health Medical LLCGroup PAC ID 0547666919, 12 clinicians

Practice addresses (Care Compare)

4426 18TH Ave
Brooklyn, NY 11204-1201
Phone (212) 734-6621

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020367NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based CurrentSince Jul 1, 2018 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Nov 1, 2021 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Nov 1, 2021 Accepting new patients
Kingsbrook Medical Associates PC CurrentSince Dec 19, 2016 Accepting new patients

Locations

585 Schenectady Ave
Brooklyn, NY 11203
Phone (718) 604-0461

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

50 Water St
Fl 3
New York, NY 10004

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 9

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": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1073065397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 E 26TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103726",
            "telephone_number": "718-377-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4426 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041201",
            "telephone_number": "718-854-0001",
            "fax_number": "888-530-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALIMHAIEM",
        "first_name": "MENACHEM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-03",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.