Individual provider Active NPI

Shahana Perveen, MD

  • Neonatal-Perinatal Medicine Physician
  • New York, NY
National Provider Identifier
1104986033
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
001464 Issued in NY
Practice address
1901 1St Ave
New York, NY 10029-7404
Phone
(212) 423-6205
Fax
(212) 534-7831
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 001464 NY Primary

Addresses

Primary practice location

1901 1St Ave
New York, NY 10029-7404

Mailing address

204 Birch Dr
Manhasset Hills, NY 11040-2322
Phone (516) 414-1962

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
I20101109000426 NY Practitioner - Pediatric Medicine 0143415729 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001464NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Long Island Jewish Healthcare CurrentSince Aug 18, 2010 Accepting new patients
North Shore Long Island Jewish Health Care Inc CurrentSince Aug 18, 2010 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients
South Shore University Hospital Past Accepting new patients
North Shore University Hospital Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 6

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104986033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 BIRCH DR",
            "city": "MANHASSET HILLS",
            "state": "NY",
            "postal_code": "110402322",
            "telephone_number": "516-414-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297404",
            "telephone_number": "212-423-6205",
            "fax_number": "212-534-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERVEEN",
        "first_name": "SHAHANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "001464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.