Individual provider Active NPI

Syed Shah Hasanuddin Qadri, MD

  • Interventional Cardiology Physician
  • Floral Park, NY
National Provider Identifier
1104040369
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
259223 Issued in NY
Practice address
26701 Hillside Ave
Floral Park, NY 11004-1743
Phone
(718) 343-7790
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 259223 NY Primary
Cardiovascular Disease Physician 207RC0000X 259223 NY

Addresses

Primary practice location

26701 Hillside Ave
Floral Park, NY 11004-1743

Mailing address

26701 Hillside Ave
Floral Park, NY 11004-1743
Phone (718) 343-7790

Other identifiers 1

IdentifierTypeStateIssuer
03415625MedicaidNY

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
I20120601000002 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8729146634 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26701 Hillside Ave
Floral Park, NY 11004-1743
Phone (718) 343-7790

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Medical Provider PC CurrentSince Apr 23, 2012 Accepting new patients
Nys Cardiovascular Services PC Interventional Cardiology CurrentSince Apr 27, 2017 Accepting new patients

Locations

907 Hempstead Tpke
Franklin Square, NY 11010
Phone (516) 270-2805

26701 Hillside Ave
Glen Oaks, NY 11004
Phone (347) 894-9531

Networks

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

Interoperability endpoints

  • Direct secure messaging: sqadri64527@northwell.direct-ci.com

Organizations & group practices 2

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1104040369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26701 HILLSIDE AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041743",
            "telephone_number": "718-343-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26701 HILLSIDE AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041743",
            "telephone_number": "718-343-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QADRI",
        "first_name": "SYED SHAH",
        "middle_name": "HASANUDDIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "259223",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "259223",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03415625",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

Verify at the official NPI Registry.