Muhammad Shah Alam, MD
Individual provider Active NPI Pediatrics Physician · Brooklyn, NY
NPI 1083759641 · NPPES record last updated Mar 22, 2012
Key facts
- NPI
- 1083759641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 228414 (NY)
- Practice address
- 2926 Pitkin Ave
Brooklyn, NY 11208-3422 - Phone
- (718) 647-4724
- Fax
- (718) 647-6061
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
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 |
|---|---|---|---|---|
| I20080520000525 | NY | Practitioner - Family Practice |
7719952043 |
Reassigns benefits to 1 organization Practice locations: Brooklyn, NY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 228414 | NY | MD | Pediatrics Physician |
| 18958 | KY | MD | General Practice Physician |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahava Medical and Rehabilitation Center, LLC | Current |
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 H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 228414 | NY | Yes |
Addresses
Primary practice location
2926 Pitkin Ave
Brooklyn, NY 11208-3422
Mailing address
2926 Pitkin Ave
Brooklyn, NY 11208-3422
Phone (718) 647-4724
Other providers in Brooklyn, NY
- Juhayer Sakif Alam
- Khursheda Ann Alam
- Mahmood Alam
- MD Didar Ul Alam
- MD N Alam
- Shaheen Ara Alam
- Shaheer Alam
- Sultana Alam
- Tamara Towshin Alam
- Ihab Jamil Alamar
All providers in Brooklyn, NY · Pediatrics 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 Mar 22, 2012. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.