NPIMap

Individual provider Active NPI

Shaden Alfallay

  • Internal Medicine Physician
  • Jamestown, NY
National Provider Identifier
1114389293
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
301020 Issued in NY
Practice address
15 S Main St
Suite 150 Internal Medicine
Jamestown, NY 14701-6626
Phone
(716) 484-8610
NPI assigned
Mar 28, 2016
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 301020 NY Primary

Addresses

Primary practice location

15 S Main St
Suite 150 Internal Medicine
Jamestown, NY 14701-6626

Mailing address

194 E 2ND St
4D
New York, NY 10009-7717

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shaden.i.alfallay@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191217002495 NY Practitioner - Internal Medicine 8729326293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

15 S Main St
Suite 150
Jamestown, NY 14701-6627
Phone (814) 484-8610

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Qpharma Inc CurrentSince Feb 23, 2025 Accepting new patients
Jamestown Area Medical Associates, L.L.P. Internal Medicine CurrentSince Jun 1, 1997 Accepting new patients
Great Lakes Physician Practice PC Internal Medicine CurrentSince Oct 21, 2019 Accepting new patients

Locations

15 S Main St
Jamestown, NY 14701
Phone (607) 846-2030

15 S Main St
Ste 150
Jamestown, NY 14701
Phone (716) 483-6700

31 Sherman St
Ste 2400
Jamestown, NY 14701
Phone (814) 483-5306

2 Hot Metal St
Pittsburgh, PA 15203
Phone (412) 235-5300

Interoperability endpoints

  • Direct secure messaging: shaden.i.alfallay@upmcdirect.com

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1114389293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 E 2ND ST",
            "address_2": "4D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST",
            "address_2": "SUITE 150 INTERNAL MEDICINE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016626",
            "telephone_number": "716-484-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFALLAY",
        "first_name": "SHADEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2024-01-25",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "301020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shaden.i.alfallay@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.