Medical Professional Healthcare Woodside P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MEDICAL PROFESSIONAL HEALTHCARE WOODSIDE P.C.

Practice address

6527 Roosevelt Ave # 1a
Woodside, NY 11377-2927

Phone

(718) 550-2273

Fax

(718) 550-2274

NPI assigned

Oct 14, 2021

Organization subpart

No

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

Authorized official

Name

Shahida Khan, MDNPI 1245338300

Title

Ceo

Phone

(718) 550-2273

Specialties & licenses 1

Addresses

Other names 1

• MEDPRO Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shahida Khan, M.D.

  • Internal Medicine Physician
  • Woodside, NY
  • NPI 1245338300
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1124781398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6527 ROOSEVELT AVE # 1A",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772927",
            "telephone_number": "718-550-2273",
            "fax_number": "718-550-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6527 ROOSEVELT AVE # 1A",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772927",
            "telephone_number": "718-550-2273",
            "fax_number": "718-550-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PROFESSIONAL HEALTHCARE WOODSIDE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-14",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHAHIDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-550-2273",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@medprocare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6527 Roosevelt Ave # 1A",
            "city": "Woodside",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113772927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MEDPRO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDPRO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Christine McGovern, M.S.ED.
• Edward M McMorris I
• Brian T McNeary, M.D.
• Thomas Meade, LMT
• Medical Care at Home, PC
• Angelgana Medina Pena, LMSW
• Carlos Napoleon Meehan
• Brigid Pegeen Mehegan
• Rolando Mario Melendez, DPM
• Patricia Melo-Kennedy

• Primary Care Clinic/Center in Woodside, NY
• Providers in Woodside, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.