Individual provider Active NPI

Sherry Shieh, M.D.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1083696447
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
221355 Issued in NY
Practice address
928 Broadway
Suite 204
New York, NY 10010-6008
Phone
(212) 982-8229
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 221355 NY Primary

Addresses

Primary practice location

928 Broadway
Suite 204
New York, NY 10010-6008

Mailing address

928 Broadway
Suite 204
New York, NY 10010-6008
Phone (212) 982-8229

Other identifiers 1

IdentifierTypeStateIssuer
02691946MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology, Laser and Surgery of Flatiron PLLC Dermatology CurrentSince Jan 7, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai Dermatology Past Accepting new patients
Beth Israel Medical Center Dermatology Past Accepting new patients
St Lukes-Roosevelt Hospital Center Dermatology Past Accepting new patients

Locations

928 Broadway
Ste 204
New York, NY 10010
Phone (212) 982-8229

Networks

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

Organizations & group practices 4

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1083696447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 BROADWAY",
            "address_2": "SUITE 204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106008",
            "telephone_number": "212-982-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 BROADWAY",
            "address_2": "SUITE 204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106008",
            "telephone_number": "212-982-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIEH",
        "first_name": "SHERRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "221355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02691946",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.