Individual provider Active NPI

Muhammad Shah Alam, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1083759641
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
228414 Issued in NY
Practice address
2926 Pitkin Ave
Brooklyn, NY 11208-3422
Phone
(718) 647-4724
Fax
(718) 647-6061
NPI assigned
Feb 21, 2007
Last updated
Mar 22, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 228414 NY Primary

Addresses

Primary practice location

2926 Pitkin Ave
Brooklyn, NY 11208-3422

Mailing address

2926 Pitkin Ave
Brooklyn, NY 11208-3422
Phone (718) 647-4724

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
I20080520000525 NY Practitioner - Family PracticePractitioner - Emergency Medicine 7719952043 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18958KYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Nov 1, 2016 Accepting new patients
Jenkins Healthcare Company Inc Past Accepting new patients
Jenkins Community Hospital Dba Jenkins Community Hospital Past Accepting new patients

Locations

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

Networks

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

Organizations & group practices 3

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1083759641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 PITKIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083422",
            "telephone_number": "718-647-4724",
            "fax_number": "718-647-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 PITKIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083422",
            "telephone_number": "718-647-4724",
            "fax_number": "718-647-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAM",
        "first_name": "MUHAMMAD",
        "middle_name": "SHAH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "228414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.