NPIMap

Individual provider Active NPI

Farid Shahkoohi, M.D.

  • Internal Medicine Physician
  • Rockville Centre, NY
National Provider Identifier
1124024336
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
204265 Issued in NY
Practice address
371 Merrick Rd
Ste 302
Rockville Centre, NY 11570-5301
Phone
(516) 678-5555
Fax
(516) 678-9128
NPI assigned
Jun 22, 2005
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 204265 NY Primary

Addresses

Primary practice location

371 Merrick Rd
Ste 302
Rockville Centre, NY 11570-5301

Mailing address

371 Merrick Rd
Ste 302
Rockville Centre, NY 11570-5301
Phone (516) 678-5555

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
I20050620001001 NY Practitioner - Internal Medicine 1658316773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York Downstate Medical Center, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charles a. Mitgang, M.D. P.C.Group PAC ID 6709948417, 2 clinicians
Rock Medical PCGroup PAC ID 4082132113, 2 clinicians

Practice addresses (Care Compare)

371 Merrick Rd
Suite 407
Rockville Centre, NY 11570-5301
Phone (516) 678-5555

88 -14 Sutphin Blvd 2ND FL
Jamaica, NY 11435-3711
Phone (718) 568-9120

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

State licenses

LicenseStateTypeSpecialty
204265NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Medical PC CurrentSince Feb 20, 2025 Accepting new patients
9301 Health Medical Corner PC Internal Medicine Current Accepting new patients
East Rockaway Center LLC Past Accepting new patients
Mercy Medical Services PC Internal Medicine Past Accepting new patients
Grand South Point LLC Past Accepting new patients
Mercy Medical Center Past Accepting new patients
Grandell Rehab & Nursing Ctr Inc Past Accepting new patients
South Nassau Communities Hospital Past Accepting new patients

Locations

35 Spencer St
Ste 200
Brooklyn, NY 11205

9301 Roosevelt Ave
Jackson Heights, NY 11372
Phone (212) 777-8566

8814 Sutphin Blvd
Fl 2
Jamaica, NY 11435
Phone (718) 568-9120

243 Atlantic Ave
Lynbrook, NY 11563
Phone (516) 599-2744

Organizations & group practices 9

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1124024336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 MERRICK RD",
            "address_2": "STE 302",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705301",
            "telephone_number": "516-678-5555",
            "fax_number": "516-678-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 MERRICK RD",
            "address_2": "STE 302",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705301",
            "telephone_number": "516-678-5555",
            "fax_number": "516-678-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHKOOHI",
        "first_name": "FARID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "204265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.