NPIMap

Individual provider Active NPI

Shahriar Joseph Khalili, MD

  • Cardiovascular Disease Physician
  • East Patchogue, NY
National Provider Identifier
1124079173
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
181137 Issued in NY
Practice address
285 Sills Road
Building #14
East Patchogue, NY 11772-4869
Phone
(631) 447-8300
Fax
(631) 447-8872
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 181137 NY Primary

Addresses

Primary practice location

285 Sills Road
Building #14
East Patchogue, NY 11772-4869

Mailing address

285 Sills Road
Building #14
East Patchogue, NY 11772-4869
Phone (631) 447-8300

Other identifiers 1

IdentifierTypeStateIssuer
01266086MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skhalili238845@nyumc.direct-ci.com

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
I20070720000828 NY Practitioner - Cardiovascular Disease (Cardiology) 3476654435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
State University of New York Downstate Medical Center, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

250 Patchogue Yaphank Rd
Suite 5
East Patchogue, NY 11772-4862
Phone (631) 654-3330

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

285 Sills Rd
East Patchogue, NY 11772-4869
Phone (631) 475-2858

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Hospital & facility affiliations

  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
181137NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Community Hospital at NYU Langone Health CurrentSince Sep 1, 2013 Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. CurrentSince Sep 1, 2013 Accepting new patients
New York University Cardiovascular Disease CurrentSince Oct 1, 2018 Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. Current Accepting new patients
New York University Cardiovascular Disease CurrentSince Oct 1, 2018 Accepting new patients
Long Island Cardiology Associates, LLP Cardiovascular Disease Past Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. Past Accepting new patients

Locations

285 Sills Rd
Bldg 14
East Patchogue, NY 11772
Phone (631) 447-8300

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

Networks

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

Interoperability endpoints

  • Direct secure messaging: skhalili238845@nyumc.direct-ci.com

Organizations & group practices 8

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.

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1124079173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS ROAD",
            "address_2": "BUILDING #14",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-447-8300",
            "fax_number": "631-447-8872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS ROAD",
            "address_2": "BUILDING #14",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-447-8300",
            "fax_number": "631-447-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALILI",
        "first_name": "SHAHRIAR",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "181137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01266086",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skhalili238845@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "285 Sills Road",
            "address_2": "Building #14",
            "city": "East Patchogue",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117724869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.