Individual provider Active NPI

Remonda K Abdel-Shahid, PT

  • Physical Therapist
  • Farmingdale, NY
National Provider Identifier
1104859479
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026817 Issued in NY
Practice address
22 Florgate Rd
Farmingdale, NY 11735-2010
Phone
(646) 427-0353
NPI assigned
Jul 9, 2006
Last updated
Dec 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 026817 NY Primary

Addresses

Primary practice location

22 Florgate Rd
Farmingdale, NY 11735-2010

Mailing address

22 Florgate Rd
Farmingdale, NY 11735-2010
Phone (646) 427-0353

Other identifiers 1

IdentifierTypeStateIssuer
03139017MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080728000511 NY Practitioner - Physical Therapist in Private Practice 7911071717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5630 Myrtle Ave
Ridgewood, NY 11385-4736
Phone (718) 400-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyvale Physical Therapy PLLC Physical Therapist CurrentSince Nov 3, 2014 Accepting new patients

Locations

11624 Queens Blvd
Forest Hills, NY 11375
Phone (718) 275-4700

5630 Myrtle Ave
Ridgewood, NY 11385
Phone (718) 400-7000

Networks

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

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, 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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1104859479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 FLORGATE RD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352010",
            "telephone_number": "646-427-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 FLORGATE RD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352010",
            "telephone_number": "646-427-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDEL-SHAHID",
        "first_name": "REMONDA",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03139017",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.